Every Friday, a group of San Francisco foster youth who are part of a program intended to help them successfully transition into adulthood meet. Today, the four young people are gathered to discuss something that foster parents, social workers and the foster care system have a notoriously hard time talking about: sex.
Paulisha Green, 24; Lynette Davis, 20; JayDee Perez-Lockwood, 24; and Ka’Tina Jackson, 21 are discussing who told them about sex in the absence of their biological parents.
“Definitely not my grandpa, Paulisha Green says, laughing. As a child, Green was raised by her grandparents after her mom and dad lost their parental rights.
“Soon as the female reproductive system started kicking in he was like ‘Oh my God!’ That was it. He didn’t want to hear anything.”
Whether extended family or foster parents, there is no uniformity in training on how caretakers should address this critical issue, and such a lack of comprehensive sexual education for youth in foster care has a significant correlation with high pregnancy rates and contraction of sexually transmitted diseases among other negative outcomes. Despite these stark facts, the system has been slow to make meaningful reforms in this arena, but now as attention mounts there is an increasing will for change.
Seventy one percent of young women who have been in foster care report having been pregnant at least once by age 21, and of these women, 62 percent had been pregnant more than once. Youth in care are 2.5 times more likely than youth in the general population to get pregnant at least once before they turn 20, according to the National Campaign to Prevent Teen and Unplanned Pregnancy (NCPTUP).
“I don’t want to stigmatize youth in foster care as if they are the only ones getting pregnant. There needs to be consistency for any child who attends schools in the U.S. to receive appropriate sex education, but we know that doesn’t happen,” says Paula Parker-Sawyers, Senior Director of Outreach and Partnerships at NCPTUP.
“Because of the circumstances that youth in care find themselves in they happen to be at a greater risk, and they need that extra help.”
Rick Barth, the Dean of the University of Maryland’s School of Social Work, has studied the heightened rates of teen pregnancy in foster youth for years, and sees the lack of caretaker training as one of the principal obstacles in efforts to reduce unwanted pregnancies.
“If a youth has a diaphragm or a condom and they are 13 years old what is the foster parent supposed to say? If they are 13, they could be having sex with someone who is 19 or 20 should, what should they [the foster parents] do? Is the foster parent supposed to check whether or not they are being statutorily raped? Or say: ‘I am happy you found family planning methods.’”
“These are not simple questions.”
And the issues these youth face extends beyond pregnancy.
In a 2010 study by the University of Washington, researchers found that both male and female participants who had been in care had higher sexual risk behaviors than their non-fostered peers. Female participants were more likely to have Trichomonas, a common sexually transmitted disease, than girls who hadn’t been in care, and the males were more likely to have Gonorrhea and Chlamydia than their peers who had never been in care.
“We don’t feel you can conclude from our findings that it is due to them having experienced foster care, but they are more likely due to early life experiences that resulted in them being in foster care,” says Dr. Kym Ahrens, lead author of the study, about why youth in care experience higher risk of STDs.
During the Friday meeting in San Francisco, Lynette Davis says the best sex talk she received, after she entered foster care at 13, was from her very blunt and demonstrative high school health teacher.
“That’s what I think some of us need when it comes to sex. I never heard the whole birds and the bees thing, but to be honest I don’t want to hear anything like that. Just give me the full details because in reality I’m not no bird and he’s not no bee so just give it to me straight,” Davis says.
Randy Ruth, board member of the National Foster Parent Association as well as a foster parent and former social worker, says foster parents do want to have the sex talk with the youth they serve but it depends on the relationship they have.
“It depends on the kid, their age, the family they came from, and what they seem to already know. So many have observed so much before they’ve entered foster care,” Ruth says.
A Home Within is a non-profit organization, which provides free lifetime therapy to foster youth. Executive Director Dr. Toni Heineman says addressing sexual abuse along with developing ideas of positive relationships is essential to helping youth engage in safe and healthy sexual behavior.
“One of the things we find with kids coming into care who have experienced [sexual] abuse is they have a very hard time reading signals,” Heineman says. A simple gesture like a hand on the shoulder can be perceived in multiple ways by an overly sexualized or overly sensitive teen, Heineman adds. While the majority of youth in care don’t enter the system because of sexual abuse, for those who do or have experienced hypersexual behavior in their homes, sexual education is critical.
“They’ve witnessed things that they may not have the emotional or cognitive ability to process.”
Dr. Heineman says that along with therapists, foster parents and case workers and as many adults as possible who come in contact with youth who’ve experienced unhealthy sexual behavior need to help them counter destructive models of relationships with discussions of more positive images and behaviors.
“I asked my foster mom about [sex] but she wouldn’t talk to me about it until about fifth grade,” says Perez-Lockwood, leaning on his left elbow with his head tilted downward as he talks to the other ILSP youth, “and the only reason she told me about it was because I had a sexual altercation when I was in fifth grade that shouldn’t have happened. ”
Perez-Lockwood grew up in foster care from birth until he was emancipated at age 18. Between ages five-14 he lived with this foster mother who helped him address the abuse he experienced so young.
“Every year since then she reminded me of it and made me ask questions. I used to have memories of stuff happening when I was little and I wasn’t sure if it was sex, so I had to ask her. It helped me know what was right and wrong when it comes to sex.”
After 14, he moved to another home, which would be one of five during his time in care. The sex talks stopped.
Thanks to an increasing amount of research in recent years about the sexual behaviors and outcomes of youth in care, more state and federal agencies are starting to address the need for proper sexual education for teens in foster care.
Twenty-one states have taken advantage of funding from the Office of Adolescent Health in the U.S. Department of Health and Human Services to implement evidence-based teen sexual health programs with a specific target of youth in foster care. Implementing these programs costs approximately $13 million dollars, compared to the $2.3 billion dollars in teen child bearing costs within child welfare in 2004, according to the NCPTUP.
The NCPTUP is currently working with the University of Virginia to adapt the evidence –based teen health programs being implemented into foster care specific programs. Five states—Hawaii, California, Minnesota, North Carolina, Rhode Island—are serving as pilot sites for the newly developed curriculum which hopes to reduce the risk of pregnancy and unhealthy sexual behaviors.
While child welfare leaders are hopeful, they recognize that implementation will vary from state to state and that teaching kids about sex is only one part of pregnancy prevention and the other adverse of effects of early, un-protected sex.
As Professor Barth points out: “It is great to teach kids skills, but until we are free and clear to ensure that foster parents and workers are getting kids to family planning clinics we are not going to have the kind of impact we need.” He says that access to medically-based, long-lasting contraceptives like Depo-Provera shots and birth control are needed. “Until we start using those tools to their full capacity not going to help kids as much as we could.”
Ka’Tina Jackson says no one talked to her about contraception at her aunt’s home, or the two group homes where she stayed. Jackson thinks if someone had talked to her, maybe she wouldn’t have had her son JaMarcus at age 17.
“I met a girl Saturday who said, ‘I had a baby so I could grow up and show the system I could make it own my own.’ And I thought how do you think that shows anything? It does make you grow up but it doesn’t happen right away,” says Jackson.
“A lot of youth in foster care are trying to establish a family. They’re looking for attention,” Green says to Jackson.
“You grow up in the system and you feel like nobody loves you, nobody cares for you, and long story short, you look for love in all the wrong places,” Davis adds.
All four youth sitting around this Friday afternoon agree there is no guarantee that if a foster parent, or a social worker, or a health program provider take on the responsibility of speaking to a teen about sex, they will automatically reduce that young person’s risk of pregnancy and contracting an STD.
As Paulisha Green explains, each youth in care needs to learn not only the risks of sex, but the value of love.
“They need to know who they are and that they are somebody, so that they don’t have to go out there doing everything and everybody,” she says.
All four youth around the table nod their heads in agreement.
Daniel Heimpel contributed to this story.