Tag: puberty

Disability and Sexual Health Education

Posted on by Nicol Walsh

Washington’s Comprehensive Sexual Health Education helps all students learn about their bodies, relationships, and sexual health through age-appropriate, inclusive curriculum.

A Brief Overview

  • Sexual education is a legal requirement in Washington State. Read on for information about what the state requires and resources for supporting a child to learn developmentally appropriate information related to health and sexuality.
  • The state provides a Sexual Violence Prevention website page with information about work underway toward the prevention of child sexual abuse.
  • Helping young people talk about sexual consent can support students to learn to make healthy choices that serve them for a lifetime. Rooted in Rights of Washington offers a step-by-step guide for talking about consent with youth with disabilities.
  • May is Sex Ed for All Month. Sex Ed for All Month is an opportunity to raise awareness and call for real investment in sex education in schools and communities across the country.

Introduction

Parents or guardians are their child’s first and primary teachers about sexual health education. What parents and caregivers believe, say, and do can shape how children learn about their bodies and relationships. This article shares resources to help families and youth support healthy sexuality and understand what schools are required to teach.

Why should students learn about sexual health in school?

Everyone has the right to autonomy over their own body and needs the knowledge and tools to make informed, safe choices for themselves. Restricting knowledge or making choices for other people can lead to situations where that lack of knowledge increases their vulnerability. That vulnerability, especially for a young adult with a disability, can lead to unsafe choices both personally and through others’ predatory behavior. What are my rights? What is important to know about my own health and safety? How do I understand my own and others’ behaviors and feelings? Answers to these questions are important tools for growing young adults, regardless of their circumstances or diagnosed cognitive abilities.

Washington’s Sexual Health Education Laws

Washington state law requires schools to provide education about the life-threatening dangers of HIV/AIDS, how it spreads, and how to prevent it. Students must begin learning HIV/AIDS prevention education by grade 5 and review it annually, in accordance with the AIDS Omnibus Act (RCW 28A.230.070). Office of the Superintendent of Public Instruction (OSPI) offers guidance, teaching materials, and support to help schools teach HIV/AIDS prevention and sexual health education in ways that are accurate, age-appropriate, and inclusive of all students.

In 2018, Washington legislature passed Erin’s Law (HB 1539), which aims to prevent child sexual abuse. The law names OSPI as the lead agency responsible for reviewing curricula and working with Department of Children, Youth, and Families (DCYF) to create child sexual abuse prevention programs in grades K-12. OSPI provides a Sexual Violence Prevention webpage that includes information about work underway.

Comprehensive Sexual Health Education (CSHE)

Washington schools are required to teach inclusive comprehensive sexual health education (CSHE). Educational materials must follow the Health Education K-12 Learning Standards, which provide a framework for comprehensive instruction, and the provisions of Washington State Law RCW 28A.300.475. Families can review these materials to understand better  what their child is learning.

For students in grades 4-12, CSHE is defined in the law as “recurring instruction in human development and reproduction that is medically accurate, age-appropriate and inclusive of all students…using language and strategies that recognize all protected classes.” Disability is a protected class, which means students with disabilities must be included in sexual health education.

Instruction for students in grades Kindergarten-3 is defined in the law as Social Emotional Learning (SEL). Lessons for these grades do not include human development or reproduction. OSPI provides a Social Emotional Learning webpage with helpful tools for families, like fact sheets and infographics.

Consent and Decision Making

CSHE teaches about consent and helps students develop the communication and decision-making skills they need to make healthy choices. Consent is defined as granting permission for something to happen or agreement to do something. Consent is important to understand in the context of sexual activity. Rooted in Rights of Washington provides written information and a video within its step-by-step guide for talking about consent with youth with disabilities.

Dating and sexual intimacy are subjects that can be addressed through Supported Decision Making, a legal option in Washington State. Washington law (Chapter 11.130 in the Revised Code of Washington) includes Supported Decision Making (SDM) as an option under the Uniform Guardianship, Conservatorship, and Other Protective Arrangements Act. The format for an SDM agreement is up to the individual and their supporters. A sample form is available for download from WashingtonLawHelp.org.

Sex Ed for All Month

May is Sex Ed for All Month, an opportunity to raise awareness and call for real investment in sex education in schools and communities across the country. Sex Ed for All Month is coordinated by the Sex Education Collaborative, in collaboration with a national coalition of sexual and reproductive health, rights, and justice organizations committed to ensuring equitable and accessible sex education for all young people nationwide.

Learn More

OSPI’s Comprehensive Sexual Health Education Implementation webpage offers educational materials and tools that help teach about relationships, including social skills, friendships, and personal responsibility for one’s body.

The Healthy Teen Network provides tips, tools, and information to help youth learn about relationships, understand their bodies, and make healthy choices.

The Center for Parent Information and Resources provides a library of resources, including several related to the role of parents: Sexuality Education for Students with Disabilities.

Gender Affirming Care

Posted on by Nicol Walsh

A Brief Overview

  • Sex and gender are separate, but related concepts.
  • Transgender and gender diverse individuals have special health care needs, but are the most likely to be dissatisfied with their health care or avoid medical care.
  • Gender affirming care is about knowledge and understanding, which can lead to better health care outcomes for individuals who are transgender or gender diverse.

Gender identity has become a hot topic in today’s political world. But beyond the politics, there are many young people that are struggling and often it is their physical and mental health that suffers the most from the misunderstanding between sex and gender, and the meaning of gender affirming care.

What is the difference between sex and gender?

Sex is determined by chromosomes passed down through genetics, with XY being male and XX being female. These chromosomes are responsible for the majority of our sexual-based differences, including genitals and hormones.  Most people are born with either XY or XX but not everyone is.

Gender, on the other hand, is a ‘social construct’ based on an individual’s apparent sex. Gender refers to an expressed societal norm often attached to a person’s sex, so a person with XX chromosomes would be expected to be feminine. For centuries, the English words sex and gender have been used interchangeably, so female and woman meant essentially the same thing.  Modern sociologists and psychologists state that although these terms are tightly bound together, they are not synonyms. 

Individuals who have a gender in alignment with their biological sex chromosomes are known as cisgender, while those whose gender is different than their biological sex chromosomes are known as transgender. Individuals whose gender does not fit neatly in either category are known as non-binary, genderfluid, or genderqueer, and are often referred to as gender diverse.  Some societies, including several Native American/Native Alaskan communities, recognize a third gender. Two-Spirit is a common term used in many indigenous communities throughout the Americas that encompasses cultural, spiritual, sexual, and gender identity.

What health care issues are there for individuals who are transgender or gender diverse?

Transgender persons are more likely to need some specialized care than their cisgender peers. Healthcare issues that disproportionately effect the trans community include sexually transmitted infections, depression, and substance use. These healthcare issues/needs are not solely due to the person being transgender but due to societal and medical ignorance and/or discrimination. Medical interventions can lessen the impact of these health issues, if an individual can find medical experts that they trust.

Transgender and gender diverse individuals are often more hesitant to go to a doctor because of perceived prejudices or past negative experience with doctors. According to the National Institute of Health, “Transgender men and women had the highest prevalence of being “not at all satisfied” with the healthcare they received.” In another survey, 29.3% of transgender and gender-diverse individuals said that they had experienced health care discrimination, and 21.6% postponed care due to fear of discrimination. This hesitancy to visit medical providers can result in the lack of preventative, and even emergency care, and negatively impact the healthcare and quality of life of transgender and gender diverse individuals.

The belief that medical personnel are not well equipped to deal with transgender patients is also felt by providers. While only around 10% of emergency department trainees surveyed felt uncomfortable treating trans patients, only 55.7% felt well prepared in attending to their transgender patient’s needs. Experts on transgender health believe that the best way to combat prejudice and lack of knowledge is through gender affirming care.

What is gender affirming care?

Despite what some political and media personalities may maintain, gender affirming care is concerned with the entirety of a person who is transgender or gender-diverse and is not wholly focused on hormones and gender-affirming surgeries.

The Standards of Care for the Health of Transgender and Gender Diverse People, Version 8 describes the goals of transgender health care services: “The goal of gender-affirming care is to partner with TGD [Transgender and Gender Diverse]  people to holistically address their social, mental, and medical health needs and well-being while respectfully affirming their gender identity. Gender affirming care supports TGD people across the lifespan—from the very first signs of gender incongruence in childhood through adulthood and into older age—as well as people with concerns and uncertainty about their gender identity, either prior to or after transition.”

What does gender affirming care look like for those under 18?

For most pediatricians, gender affirming care revolves around asking a child’s pronouns, and using those pronouns when talking to them. An awareness of disproportionate health issues, including risks to mental health, is important as well.

In some instances, puberty suppressants or hormones may be given to children or teens, but only after several visits and consultations with psychologists. Gender affirming surgeries are almost never performed on individuals under 18 years old. It is the knowledge and acceptance of a medical professional that makes the health care they provide gender-affirming.

Findings suggest that having a transgender-inclusive provider is associated with decreased rates of depression and suicidality. The Association of American Medical Colleges quotes one physician as stating “‘Most of them are happier, less depressed, and less anxious,’ says Adkins at the Duke Child and Adolescent Gender Care Clinic. “Their schoolwork often improves, their safety often improves.’”

While is illegal in Washington to deny care based on gender identity, it still may be difficult to find a healthcare provider that is transgender friendly. Word of mouth from other individuals who are transgender or gender diverse can be a great start. There is also an online LGBTQ+ Healthcare Directory which can be of assistance.

Additional Resources:

Gender Affirming Medical Coverage Rights – Both state law and the federal Affordable Care Act prevent health insurance companies from discriminating against someone based on their gender identity and related medical conditions. These rights apply to youth and adults.

Lavender Rights Project – Lavender Rights Project elevates the power, autonomy, and leadership of the Black intersex & gender diverse community through intersectional legal and social services

National Center for Lesbian Rights (serves all LGBTQIA+ identities) – NCLR is a national legal organization committed to advancing the civil and human rights of lesbian, gay, bisexual, and transgender people and their families through litigation, legislation, policy, and public education.

Seattle Children’s Gender Clinic Patient & Family Education – Includes resources for working with Seattle Children’s and general education documents regarding gender affirming care.