adolescent health and confidence in who we are [by graham lister, chair of bot]

Posted by Adrienne Lee

Mon, 13 Feb 2017

The WHO report “Health for the World’s Adolescents” published in 2014 highlights the fact that worldwide, for those between 10 and 19, depression is the predominant cause of illness and disability and suicide is one of the top three causes of deaths. For those countries where survey data were available, 5% to 15% of younger adolescents (ages 13–15) reported a suicide attempt in the 12 months before the survey. Adolescence is a period of exploration and discovery when we develop our understanding of and hopefully confidence in, our sexuality, body image and our relationships. The Medsin affiliate, Sexpression: UK here empowers young people to make decisions about sex and relationships by engaging students in running informal but comprehensive sex and relationship education sessions for adolescents in the community. In this brief note I explore some questions that Medsin may wish to address in respect of youth health and confidence in the UK and globally.

In the UK the Office for National Statistics report that in 2015, 3.3% of people aged 16 to 24, identifying themselves as LGB, the largest percentage within any age group. This survey seems to assume that sexuality is binary, which it clearly is not. Even in the Kinsey Report of 1948 sexuality was measured on a six-point spectrum. A 2015 YouGov poll found 49% of young people between the ages of 18 and 24 defined themselves as something other than completely heterosexual. Moreover, this does not answer the question “How many young people worry about their sexuality?” to which I would be surprised if the answer were not “All of us”.

In some countries anxiety about sexual identity is reinforced by national laws, 84 countries still outlaw homosexuality. The UN Human Rights Commission (UNHRC) recognised LGBT rights in 2011 and the following year published a report documenting violations of these rights, urging all countries to enact laws that would protect them.  In 2016 the UNHRC passed a resolution to appoint an “independent expert” to find the causes of violence and discrimination against people due to their gender identity and sexual orientation, and discuss with governments about how to protect those people. The milestone resolution has been seen as the UN’s “most overt expression of gay rights as human rights”.

WHO still faces obstacles in addressing this issue, until 1992 it classified homosexuality as a “mental illness”. As recently as 2013, Egypt blocked a WHO discussion on LGBT health. And there are ongoing discussions on the classification of transgender sexual identity (see the article in the current WHO Bulleting here)  It therefore remains important for Medsin to raise LGBTQI health rights as an crucial aspect of Youth and Global Health through the IFMSA at WHA. The WHO 2014 report called for an approach to adolescent health, including a social response that engages and listens to their concerns about sexuality and the many other different aspects of identity.

Thus for example, body image anxiety inflamed by distorting media focus and advertising that promotes unrealistic stereotypes is also a global issue affecting adolescent health. Anxiety about body image can have a seriously negative impact on health, leading to depression, suicide, anorexia and bulimia. The UK All Party Parliamentary Group on Body Image in 2012 found: half of all girls questioned and one quarter of boys believe their peers have body image problems, 60% of girls and 20% of boys have been on a diet to try to lose weight by the age of 16. By their early 20s: 12% of girls and 8% of boys have used diet pills, 8% of girls and 1% of boys have made themselves vomit, and 5% of girls and 2% of boys have used laxatives to lose weight. Another example relates to racial and religious identity, awareness of which develops during adolescence. Without support, racial and religious stereotyping can be confusing and even lead to isolation and extremism. People with physical and mental disabilities struggle to come to terms with their identity, as I saw as the Chair of Trustees of a charity that provided a school for children with special needs. But I also saw the joy of these youngsters when they overcame their obstacles.

Each of these dimensions of identity development can be the focus of bullying at schools. Stonewall estimated in 2012 that two thirds of lesbian, gay and bisexual young people reported experiencing homophobic bullying at school.  Beat (Beating eating disorders) conducted a survey of 600 young people in the UK and found that at least 90 percent of respondents admit to being bullied at some time in their lives, and more than 75 percent of individuals suffering from an eating disorder state that bullying is a significant cause of their disorder. A survey by Mencap found that 80% of children with learning disabilities have been bullied. There are also reports of a rise in anti-Muslim, anti-Sikh, anti-Jewish and racial bullying in the last year sometimes linked to anti-immigrant sentiment stirred by the Brexit vote. Bullying is not only a significant cause of mental anguish, it is also a portent of social discrimination and bias at work and in our communities.

Medsin and its partner Sexpression: UK remind us that support for adolescent health issues at national and international levels can engage young people at local levels in taking action to resolve their own mental and physical health concerns. They create a supportive culture that empowers young people to become masters of their own identity and health. The forthcoming Medsin Global Health Conference, “Gender and Health: Seeing the Spectrum” on the 25-26 February at UCL London will be an opportunity to explore these issues.

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