Male teens and boys require more consideration from the health system, particularly in relation to sexual health and family planning concerns.
In the Center for Adolescent/Young Adult Health located at Johns Hopkins’ Harriet Lane Clinic, Pediatrician Arik Marcell frequently heard complaints from young male patients regarding the condom brands that are free in schools and the community. The conversations gave him an idea.
“I created the equivalent of a free condom store in my clinic, really a large closet that they can walk in and see all the different kinds of options,” says Marcell, MD MPH ’94, assistant professor in Pediatrics within the School of Medicine with a joint appointment in the fields of Population, Family and Reproductive Health. “They are available in a variety of sizes and materials. I’ll just ask them to fill the bag with paper’ you will take with them home. After that, I’ll ask them to take a look and test them just like you would any other product you would, and discover what is the best fit for your needs.”
A specialist in the health of adolescents, Marcell has a particular focus on improving their sexual and reproductive health, which are frequently overlooked during the primary care wellness visits for the group.
While the primary health care offered to adolescents is likely to contain information on contraception as well as sexual and reproductive health, usually after they’ve had their first period, Marcell says that this isn’t the case for male adolescents.
In this article, Marcell talks about the reasons for the gender-based disparities in health care among young males, their negative effects, and options for reducing the gap.
Why are adolescents not being served when it comes to health treatment?
The interesting thing is that it’s not a reverse. In the initial years of their lives, boys are more likely to suffer from morbidity and mortality rates than girls. They’re slightly sicker throughout the first few years of childhood. However, that once they reach the age of school and as long as they appear healthy, usually parents are able to judge them as healthy. When they enter the pubertal stage, there aren’t as many factors that trigger for girls to be taken to a clinic for treatment. Of those who are admitted, providers aren’t required to offer the recommended services for sexual health and family planning treatment.
Utilizing one of the few databases that track the attendance of adolescents at well-visits between ages 5 and 17 years old, we found that the majority of adolescents went to well-visits during this time.
We must consider making changes on different levels. First, the gender-specific cultural rules for males–“be physically strong avoid emotional expression and don’t solicit help”–may not be aligned with taking good care of your well-being. It is possible to make huge strides in reframing these messages and by promoting numerous ways to be male, including taking care of yourself.
In the next step, health systems designed to help support mother and child health have not considered the best ways to help men with their health, especially in the transition from childhood into adulthood. It is essential to develop creative, financially-supported strategies to support structures that include young males. There isn’t an official Federal Office of Men’s Health, similar to what is found in other nations. The Australian national men’s health strategy is one example. It has created policies and programs that support the health of men and boys throughout the entire lifespan.
Additionally, it is the case that here in the U.S., on a service level, we don’t have an equivalent organization to ACOG, the American College of Obstetricians & Gynecologists, which concentrates on men across the life span. Some time ago, ACOG created a female adolescents’ toolkit that helped to ensure that the primary services offered specifically for female adolescents, focusing on sexual and reproductive health. There’s no other toolkit that’s done this in a way for male adolescents.
Additionally, the providers themselves are able to better educate parents and male teens on how they can serve as an advocate for sexual and reproductive health. Male adolescents often aren’t aware of what a physician can do to help them, and a lot of providers don’t know about the guidance provided by American Academy of Pediatrics and the CDC on what are the best sexual health, family planning and reproductive services they should provide male teens.
