Purpose of review Despite longstanding consensus that “sexual and reproductive health” are defined as more than merely the absence of disease, clinical care and research in adolescent sexual and reproductive health are generally framed in negative terms, with a focus on disease and risk rather than wellbeing, satisfaction, or other desired outcomes. Emphases on risk and risk mitigation have led to the promotion of practices and policies that undermine adolescent autonomy and the principles of reproductive justice. Recent findings Sexual and reproductive health care and research are evolving toward more holistic, asset-based frameworks. Clinical practice guidelines, particularly around contraceptive care, increasingly call for person-centered care. Sexual and reproductive wellbeing has been proposed as a positive outcome intended to assess fulfillment related to sexuality and reproduction. The sexual and reproductive health equity framework considers structural factors that influence health and wellbeing and calls for upending practices, policies, and systems that perpetuate injustice. Summary Adolescent sexual and reproductive health care and research must evolve to incorporate principles of reproductive justice. The concepts of sexual and reproductive health equity and sexual and reproductive wellbeing can inform our understanding of what to change and how to measure success. Pediatric clinicians should consider the unique developmental needs of adolescents as they strive to incorporate principles of justice, wellbeing, and equity into clinical care and research.
Otto et al. (Tue,) studied this question.