Background and Approach

AAP has undertaken this work with a deliberate focus on health equity and disparities in access to care. AAP develops and disseminates policies designed to achieve this. Special attention is focused on issues that leave some children more vulnerable than others. In recent years, AAP has officially recognized racism as a core social determinant of health and a driver of health inequities. It has also acknowledged its own history of bias and racist attitudes. In an effort to achieve health equity and actualize its goals to become an equitable, diverse, and inclusive organization, AAP set forth an equity agenda in 2020 to promote a diverse Academy membership, leadership and pediatric workforce; apply an equity lens to Academy policy, advocacy, and education; and equip AAP members with the capacity to foster equity in their practices, institutions, and communities.With generous support from the Collaborative for Gender and Reproductive Equity (CGRE), AAP engaged collaborators with lived experiences or who serve communities that are historically under-resourced including adolescents, federal agencies, community organizations, academic researchers, and legal experts to create a resource that supports pediatric health clinicians, community leaders, and public health professionals in identifying strategies and key partnerships to expand equitable access to reproductive health care, including comprehensive sex education, contraception, and abortion for all youth. During each project phase, AAP engaged collaborators with lived experiences or who serve under-resourced communities, including adolescents, federal agencies, community organizations, academic researchers, and legal experts.

This resource was developed with multisectoral partners who convened with the following shared understanding:

• Young people have the right to make informed decisions in matters affecting their lives.
• Young people have the right to confidentiality when accessing reproductive health services.
• Young people have the right to be included in the development of programs and policies that impact their lives.

Project approach

At the beginning of the project, AAP launched an initiative to engage with key collaborators to discuss and inform a published resource on the ramifications of expanded bans and limitations on access to sexual and reproductive health services, including comprehensive sex education, contraception, and abortion, for adolescents, families, pediatric health clinicians, and communities.

Collaborators with lived experiences, areas of specialized studies, and professional positions in sexual and reproductive health were identified and meaningfully engaged to serve as planning committee members, presenters, and participants in all phases of the project. This includes adolescents as well as academic researchers, legal experts, and representatives from federal agencies and community organizations.

First, AAP hosted a series of listening sessions focused on the current landscape of youth access to sexual and reproductive health care services and the impact of bans and limitations to access to care. Collaborators shared their perspectives, which resulted in the key themes incorporated into the agenda of a larger virtual summit. These collaborators, in addition to other identified experts, served as panelists, presenters, and participants.

During the 2021 Youth Summit on Youth Access to Reproductive Health Care, youth participated in conversations with clinical, community, and academic leaders to examine the importance of equitable access to sexual and reproductive health care, describe barriers to accessing comprehensive sex education, contraception, and abortion services, and share solutions that support and expand youth access to reproductive health care.

After the Summit, two focus meetings – one with youth from communities that are underrepresented and one with those who deliver sexual and reproductive health services to youth from communities that are underrepresented – explored the added barriers experienced by youth who are historically disenfranchised and underserved by comprehensive sex education, contraception, and abortion services. Special considerations for how clinicians and public health professionals can support and expand equitable reproductive health care access were examined.

Meaningfully engaging individuals who have been historically disenfranchised and/or adversely impacted by the issues being addressed is considered a best practice in equity-centered work. Elevating the perspectives of those directly impacted by our policies is one important way to create policy and systems changes that benefit the communities we are aiming to serve.