2016 Science Prize in Expository Writing
Disadvantaged neighborhoods often generate a sense of hopelessness among adolescents, and a female adolescent’s perceived lack of control over her life outcome may affect her confidence to advocate for her sexual health. This exacerbates an existing structural sexual disempowerment that discourages women from taking initiative in sexual experiences, as long-standing public health efforts aimed at reducing unplanned pregnancies that only distribute male condoms put women in the position of depending on the male’s willingness to use condoms. Providing access to female-controlled contraception — specifically female condoms — could empower low-income adolescent women to take greater control of their own lives by not only expanding their options of contraception and thus, reducing the likelihood of an unplanned pregnancy that could lead them to remain in a disempowering situation of poverty, but also providing the opportunity to challenge a structural sexism that expects women to submit to their sexual partners.
However, perhaps the biggest determining factor in the degree of sexual assertiveness that adolescent women adopt, and thus, their ability to successfully advocate for condom use, is the amount of agency that they feel that they are entitled to in their sexual relationships, which is influenced by broader societal norms. Currently, our culture propagates a sexual script for heterosexual relationships that places women in the position of submitting to the desires of their more dominant male partners, who are seen to take on the role of not only initiating the sexual situation, but also determining the sexual activities. These norms shape adolescents’ expectations about how men and women should act in sexual situations, and adolescent women may feel hesitant to advocate for themselves sexually, particularly when doing so would contradict the cultural expectation that they should not take initiative in sexual situations (Sanchez 2012). In fact, in a study of adolescent sexuality, researchers found that teenage boys seemed to take a more active role in their sexual experiences, and they tended to recount the various strategies that they had used in order to secure sex, whereas the girls related the experience of their first sexual encounters as something that just “happened to them” (Sanchez 2012:168). This suggests that beliefs about male dominance and female submissiveness dramatically shape young adolescents’ sexual behavior even during their first sexual experiences, and the failure to empower women during their adolescent years may reinforce deeply embedded assumptions about the degree of agency that women should have. In fact, in a study of women in the United States, ranging in age from 14 to 25, many of them reflected that they did not believe they had the right to make decisions about their birth control (Rickert, Sanghvi, & Wiemann 2002). This finding is alarming, as it suggests that many adolescent women not only do not feel confident enough to take initiative over their sexual health, but also do not feel that this is something they, as women, should do at all. For example, Shanterrica Piper, who became pregnant at age 14 and subsequently dropped out of high school, reflects that for contraception, she only used condoms if her partner brought them and never considered that she could have taken a greater role in making sure that they used birth control. Now 19, Shanterrica laments her ignorance of other options, feeling that she “could’ve gotten more than what I did get,” had she been more aware that she could have taken more agency in her sexual health. She adds, “When you want respect, you have to respect yourself to get it” (Martin 2015:1). This moving sentiment demonstrates the urgent need to provide low-income adolescent women with female condoms that give them the opportunity to challenge stereotypical sexual scripts and advocate for themselves.
It is important to make female condoms more readily accessible for adolescent women, as research shows such types of contraception are just as effective at preventing pregnancy and the transmission of STDs as male-controlled ones, if not more (French et al. 2003). Because these types of contraception can be used on the woman’s initiative without needing her partner’s cooperation or knowledge, she is better able to guarantee her own health and protect herself from sexual risks. Furthermore, researchers found that introducing female-controlled contraception such as female condoms and encouraging their use made women more likely to protect themselves by using more contraception in general. In fact, after an intervention in which sexually-active women received either female and male condoms or only male condoms, the reported use of barrier methods for those who were given both types nearly doubled (Artz et al. 2000). The fact that the simple addition of female condoms as an option enhances overall contraceptive use and results in greater protection is remarkable, and suggests that because female condoms give females greater agency, they have more negotiating power with their sexual partners. The discussion between two sexual partners about protection no longer ends if the man refuses to use a male condom. The introduction of female-controlled birth control shifts the conversation from whether or not a condom should be used to “which” condom to use (French et al. 2003). This not only increases the likelihood that some sort of contraception will be used in the encounter at all, but also leads to greater equity in the relationship. Many women who were provided free access to female-controlled contraceptives reflected, “We decided to take turns— sometimes he used his, and sometimes I used mine” (French et al. 2003:438). It is evident that female condoms enhance the position of the female as an equal partner, such that refusing sex is no longer a woman’s sole means of protecting herself (Gollub 2000). We must educate adolescents to view female-based contraception as an equally legitimate and effective alternative to the traditional male condom. Offering low-income adolescent women more choices and resources for contraception that they can control will give women more power in their relationships and empower them to take the initiative to make sure that they are as protected as possible in all sexual experiences (Rosenberg and Gollub 1992).
Female condoms can play an integral role in empowering low-income adolescent women and giving them the opportunity to develop a greater sense of self-advocacy in many ways. For example, it has been demonstrated that increasing access to female condoms can increase overall contraceptive use and reduce the likelihood of an unplanned pregnancy (French et al. 2003), which prevents negative life outcomes that could otherwise make it difficult to escape disadvantaged situations. Often, in low-income neighborhoods, the feelings of hopelessness that adolescents have toward the prospect of a better future may make it more likely that an adolescent woman who has become pregnant will surrender to the negative situation and view it as evidence that nothing she does can change her fate (Bolland 2003). Having little confidence to self-advocate and be proactive can lead a pregnant adolescent to decide to drop out of high school if she has difficulty keeping up academically or experiences the stigma or shame often associated with teen pregnancy, and she might eventually lose hope altogether about returning to school or finding a well-paid job (Schuyler Center 2008). Thus, by preventing unplanned pregnancies, female condoms can eliminate unnecessary hardship in adolescents' lives and offer them the opportunity to realize their potential and break a negative cycle of teenage pregnancy and poverty that is difficult to reverse. In addition, female condoms empower women by giving them the opportunity to advocate for themselves sexually and challenge existing gender norms that expect them to be submissive. Taking control of their own reproductive health may have positive effects on their perceived sense of control over the rest of their lives and increase their confidence in their ability to advocate for themselves.
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