Health and wellbeing during adolescence and early adulthood has significant and lasting impacts on a person’s life. Improving health outcomes and supporting young people in their decision-making not only provides immediate benefits to these young people, but has flow-on benefits into their adulthood and the health of their children.
Sexual and reproductive health (SRH) is an integral aspect of wellbeing and a human right. Young people, particularly those from marginalised groups, are vulnerable to compromised sexual and reproductive health and rights, and face particular barriers that can limit their decision-making and agency.
My PhD examines how migrant and refugee youth (MRY) make decisions and enact agency around their sexual and reproductive health. This research is part of an Australian Research Council project examining MRY sexual and reproductive health and rights. Our research is rights-based, participant oriented and multidisciplinary.
- The population
Young people grapple with a myriad of physical, social and emotional changes as they transition to adulthood, and often have limited knowledge and access to information, services and contraceptives — all of which can impede sexual and reproductive health. Australian young people are disproportionately represented in national STI rates: 75% of Chlamydia cases occur among those aged 15-24, while over half all Gonorrhoea and a third of Syphilis cases occur in those under 29.
Such vulnerabilities are particularly acute for young people from marginalised populations. Australian migrant and refugee communities have poorer health outcomes and lower service engagement than their non-migrant counterparts, and particularly poor sexual health service uptake. Moreover, many cultures have specific constructions of sexual and reproductive health, including taboos and certain expectations around sexual behaviour. MRY therefore grapple with both the challenges and experiences of young adulthood, and those of belonging to a marginalised group within Australian society. They have distinct needs, perspectives and experiences that shape their sexual reproductive health and rights.
- A rights-based approach
Sexual and reproductive health is a crucial aspect of wellbeing that has broad social and economic benefits beyond the individual. Importantly, sexual and reproductive health can only be attained through the realisation of sexual and reproductive health rights. These include reproductive rights and a range of sexual rights to make informed decisions about what happens, and when, to one’s body. Access to services, education and information are vital rights, as are rights to a safe and satisfying sexual life, rights to bodily integrity, choice of partner, gender identity and sexual orientation.
Understanding how MRY experience and actualise these rights is crucial to developing rights-based health policy and programming that supports decision-making and improves health outcomes. Existing research on Australian MRY has fixated on family and culture, emphasising intergenerational tensions, discordance between home and resettlement cultures and familial, religious, and cultural restrictions. While understanding challenges and risks faced by a population is important, this tends to frame MRY as a “problem” population, repressed and restricted by family and culture. A rights-based approach instead emphasises the active choices MRY make regarding their sexual and reproductive health.
- The Research
My research thus far has examined the factors that inform MRY decision-making. Results highlight the importance of social, emotional and relational aspects of sexual and reproductive health — aspects often neglected from mainstream medical approaches. Participants viewed social and emotional aspects of sexual and reproductive health as equally important as more traditional physiological safety and risk-avoidance considerations. As such, services, programming and education that continue to focus purely on biomedical aspects of sexual health, such as STI and pregnancy prevention, will fail to fully engage MRY.
Moreover, participants considered family and culture far less important than other aspects. While family, religious and community stigma did have a negative impact on MRY, it did not ultimately prevent them from making their own choices. Instead, MRY navigate agency around sociocultural and familial restrictions, indicating that healthcare should take a nuanced approach to culture. Policy and programming must go beyond typical biomedical constructions of sexual and reproductive health to incorporate emotional and relational factors, which MRY value as equally important and beneficial to their agency.
My current research examines the experiences and decision-making of MRY who have accessed abortion care. If you are a young person from a migrant or refugee background between the ages of 16-26 who has accessed abortion care, please consider getting involved by scanning the QR code below. If you want to hear more about the research and findings, feel free to reach out via email: [email protected].
