On the Outskirts of the Charmed Circle—Challenges and Limitations of Sexual Health Promotion to Young People in Secure State Care

Abstract

Objectives Young people on the verge of, or in, secure state care or incarceration have reduced general and sexual health. The promoting of sexual health among young people in secure state care is therefore a responsibility for both the state-run agency responsible for this care and for the professionals who work there. Methods This position paper discusses sexual and reproductive health and rights (SRHR) for young people in secure state care in Sweden. Four previous studies on sexual health of young people in secure state care are revisited, and governmental policy documents are examined. Results Young people in secure state care face many threats to their sexual and reproductive health and rights. Some of these threats originate with the institutional placement itself and the lack of knowledge among the staff. Clashes on various levels between the subjectively desired (young people seeking pleasure from sex, alcohol, or other drugs) and the societally desired (sexual health, minimal alcohol use, and no drug use among young people) are described. In addition, clashes are seen between young people who want to be like everyone else in their social context and the staff with a mission (i.e. job description) to readjust young people into adopting socially accepted behaviour. Conclusion I argue that young people in secure state care have sexual experiences that are marginalized and placed on the outskirts of the charmed (sexual) circle of societally accepted sexual behaviour. In addition, their experiences are surrounded by silence, a silence sustained by both young people and professionals. The readiness of professionals to handle SRHR for young people in secure state care in a knowledge-based and non-judgemental fashion is crucial. Future research should focus on this readiness and have the needs and wishes of young people as its departing point. Although the article involves a local context, it may be of interest to a wider audience, as the placement of young people in secure state care and other forms of incarceration occurs worldwide.

Social Workers as Allies? Gender Confirming Practices and Institutional Limitations in Youth Residential Homes

“…Last, but not least, the social workers suggest ways forward, thereby showing they are creating a trustful alliance. Overall, our findings are consistent with previous research that indicates that social care systems face difficulties meeting the needs of transgender and nonbinary youth (Erney & Weber, 2018;Gerassi & Pederson, 2022;Greeno et al, 2022;Kaasbøll et al, 2022;Lindroth, 2021;Mallon, 2019;Mountz et al, 2018;Schaub et al, 2022).…”

Sexual and reproductive health and rights (SRHR) among young people in secure state care and their non-incarcerated peers – a qualitative, descriptive and comparative study

“…Substance use is one of the reasons why they are placed in these institutions. However, the findings underscore the need to include support on matters of sexuality in social work when individuals are exiting substance use (Lindroth, 2020;Skårner et al, 2016;Svensson & Skårner, 2014;Wikström et al, 2018). Regarding their most recent sexual experience, young women in secure state care appear to have experienced less power and stated that they were more unsafe compared to the other three groups.…”

“…Similarly, young people subjected to secure state care in Sweden who display non-normative or unconventional sexual behaviours or experiences risk being met with unprofessionalism. It is suggested that young people therefore filter what experiences are societally acceptable to share with professionals, who in turn are not educationally equipped to work with sexual health promotion (Lindroth, 2020).…”

“…Following these recommendations could lead to a social work practice where well-being includes sexuality as a resource and a source of strength. A sexual rights-based perspective is needed in social work in general and with vulnerable young people in particular (Lindroth, 2020;Smith & Woodiwiss, 2016). This is especially important when social work is organised in a compulsory fashion and when young people are incarcerated.…”

First-time testers in the GetaKit study: conceptualizing new paths to care for gbMSM

“…Yes, self-testing has been positively adopted by gbMSM and has led to an increase in HIV testing overall; however, as we have stated, this is potentially due in large part to the real and perceived shortcomings within the traditional HIV prevention armamentarium. For gbMSM, who exist on the outskirts of Rubin’s charmed circle of sexuality, their ability to interface with the traditional healthcare system is dramatically reduced and they are frequently put into positions where they must find ways to help themselves or risk receiving no help at all ( Kinsler et al, 2007 ; Rubin, 2007 ; Lindroth, 2021 ; Kipke et al, 2007 ). Considering this, the uptake of self-testing can be read as a symptom of a persistent limitation of the current healthcare system, specifically its inability to take into account the sociocultural context of gbMSM who are younger and/or identify as BIPOC.…”