Reproductive and Sexual Health

SFCASA Advocacy Areas

Access to Healthcare, Independent Living Skills, Permanency

Why We Advocate

For adolescents, part of transitioning to adulthood includes learning how to navigate relationships, sexuality, sex, and reproductive health. Being in foster care means navigating these same experiences in addition to other barriers and unique challenges. For example, they may be less likely to have access to healthy relationship models as well as adequate sexual and reproductive health information and services. They are more at risk of sexual exploitation, vulnerabilities which are exacerbated for youth who may identify as LGBTQ+. They may not know how to book a sexual health appointment, not be comfortable asking their caregiver to help them book one, or struggle to get transportation to such an appointments.

This makes it much more difficult for foster youth to access to contraceptives. In California alone, 26% of young women in foster care will become pregnant by 17. Despite teen pregnancy declining overall, it is increasing for youth in care; teens in foster care are 2.5 times more likely to become pregnant than their non-foster care peers, and 20.7% of pregnant foster youth never receive prenatal care. Unintended pregnancy can significantly impact a youth’s ability to access and complete school, obtain and maintain employment, and financially support themselves. 

It is vital that young people in foster care be given full control of their bodies and reproductive decisions. Part of this autonomy requires an understanding of comprehensive sexual health information; the capacity to engage in consensual sexual activities when they choose to; knowledge of their reproductive rights; and access to healthcare that includes birth control options and sexually transmitted infection treatment and prevention. These services need to be delivered in a trauma-informed way given the trauma that young people in foster care have already experienced.

How to Advocate

There are many different ways a CASA can actively support their youth’s reproductive health needs, both behind-the-scenes and directly with their youth. Check out some of our ideas below!

Behind-the-scenes:

  • Research appropriate services, from clinics to community-based organizations providing reproductive and sexual health support and education for adolescents. See the “Partner Organizations” and “Resources/Links to Learn More” below as a starting point.

  • Make sure your youth’s school is disseminating reproductive and sexual health information to its students. In California, there is a mandate for all public middle and high schools to provide comprehensive sexual health education. Not sure if that is happening at their school? Given the Foster Youth Liaison at their school or school district a call to find out.

  • Check to see if your youth’s social worker is providing developmentally appropriate sexual health information to them, regularly informing them of their reproductive rights, helping them make appointments, and providing transportation to and from those appointments. Social workers are required by law to do all of the above. In fact, in July 2017 California adopted a new law requiring comprehensive sexual health education for youth in foster care (SB89). This also includes new training requirements for caregivers, social workers, and judges. A CASA can play a big part in ensuring their youth’s team is complying with this law.

  • Be careful about what you share in the court report. A youth’s reproductive and sexual health choices are private, and unless they explicitly state that they want you to share something with the team or in your court report, refrain from doing so. This includes birth control choices, romantic relationships, pregnancy, and STDs. 

With your youth:

  • Talk to them about their medical rights. See our “Legal” section below to learn more. You should also provide them with one of these colorful, age-appropriate guides that cover their rights based on their age and share relevant resources:

  • Talk to them about appropriate resources that they could access. See our “Resources” section below to learn more, and also use the guides linked above.

  • Ask them if there is someone they would feel comfortable talking to/being supported by when it comes to their reproductive and sexual health. It is completely normal if they do not feel 100% comfortable speaking with you about this subject. If not, make sure to connect them with someone, whether that be a family friend, caregiver, or professional either on their team or at a relevant agency, who they do feel comfortable speaking to instead.

  • Don’t be afraid to bring up the subject of safety around things like consent. Even for youth who are at a very young age, conversations around personal space, normal relationships, and how to speak up when you may be uncomfortable can be incredibly powerful and important to have. As with the point above, if they do not feel comfortable speaking about these subjects with you, connect them with someone else.

  • If appropriate, help them set up medical appointments and access care as needed. They have a legal right to access most reproductive and sexual healthcare at any age, which includes the right to transportation.

Appropriate language to use as a CASA

Talking about sex, sexual health, and sexuality can be tricky to navigate with your youth. You may be concerned about their caregiver’s value system or religion. However, remember that your youth has a right to access reproductive and sexual health services regardless of their placement situation or dynamics. You may also be worried that your youth will not be comfortable talking with you about these subjects. Ultimately, part of supporting your youth’s knowledge and understanding of their rights and available services is by nonjudgmentally and sensitively bringing this subject up with them.

The way in which you will want to approach this subject with your youth will need to be age- and developmentally appropriate. Please reference the handy one-page guides listed above in the “How to Advocate” section for ideas on how to navigate this conversation based on your youth’s age. You should even consider handing the colorful guide to your youth both as a resource and conversation starter!

In conversation, ask your youth open-ended questions like, “What does practicing safe sex mean to you?”, “When you think about safety when it comes to sex and sexual health, what comes to mind?”, “Do you know what your rights to services are? I’d love to share that with you if you aren’t sure.”, “Is there someone you would feel comfortable speaking with about these things if not me?”. Be open and honest; let your young person know when you don’t know something or are not comfortable with certain questions, and make sure to connect them to appropriate services so they can learn more.

Please reference this resource from California CASA about how to navigate a conversation with the foster youth you serve. 

Legal Rights

Foster youth have the legal right to be informed in an age and developmentally appropriate manner of sexual and reproductive health services that are available to them. At any age, foster youth have the right to:

  • Obtain and use female or male birth control and protection options, including condoms

  • Access to pregnancy testing and prenatal care

  • Receive an abortion

  • Access services that may be needed due to a rape or sexual assault

  • Confidentiality with their doctor around what services they choose to access or considering accessing

  • Transportation to appropriate services by their social worker, group home staff, or caregiver

Additionally, at the age of 12 and older, foster youth can access the following healthcare services:

  • Healthcare to prevent, test, and treat sexually transmitted infections and HIV

  • Mental health counseling

For more information on consent laws, please check out this resource.

Resources/links to learn more

Age Appropriate, Medically Accurate Sexual Health Facts

List of Resources for Parenting Foster Youth

Let's Talk About Sex by Fostering Media Connections

Teen Health Rights

Resources for Supporting Pregnant and Parenting Teens

Know Your Sexual and Reproductive Health Rights (brochure)

Consent to Medical Treatment for Foster Children

What is a healthy relationship? What is safe sex? What does consent look like?

California CASA Conversations:

Resources for Teen Parents in Foster Care

Los Angeles Reproductive Health Equity Project for Foster Youth

Partner Organizations

WIC

Hilltop High School

Homeless Prenatal Program

Alpha Pregnancy Center

YMCA Family Resource Center

Help a Mother Out

SF ILSP

Misssey

CE opportunities

If you would like to watch any of the webinars below for CE credit, please work with your Case Supervisor to determine how many hours you can receive.

Providing Comprehensive Sexual Health Education to Foster Youth: Lessons Learned from an LA Pilot

Webinars from Dept of Health & Human Services

Building a Safety Net for Teen Parents in Foster Care: California's Approach

CDSS: Healthy Sexual Development and Pregnancy Prevention for Youth in Foster Care

Improving Outcomes for Pregnant and Parenting Teens in Foster Care