The increasing number of teenage girls who are incarcerated in juvenile detention centers have enormous health care needs: 90 percent have experienced physical, sexual, or emotional abuse; 41 percent have signs of vaginal injury consistent with sexual assault; and a third have been or are currently pregnant, according to the National Girls Health and Justice Institute. For many of them, the detention centers may be their only access to health care.
But the centers’ health systems often do not match the health care needs of teenage girls — so preliminary screenings when the girls arrive are likely to miss serious issues, according to Kaiser Health News:
The door remains open for security purposes, with guards and new residents passing by. Without privacy, girls are unlikely to reveal important health information, especially when they have previously been victimized, says Leslie Acoca, a psychologist and researcher who has studied the health care of girls in detention for more than a decade. [...]
There are a handful of questions given only to girls: Are you pregnant? If so, have you started prenatal care? What form of birth control do you use?
During the screen, however, Reylene didn’t mention a major health issue: painful red burns across her breasts.
“Usually I’m pretty straightforward, but, like, I lied to [the nurse] when I first came in here, about my burns,” says Reylene, who explains that she doesn’t know exactly what happened because she was passed out when she was burned.
The nurse saw the burns through her tank top, but Reylene was evasive because she didn’t want them to be investigated. “If we’re in the detention center … we don’t know who to trust, because we’re vulnerable,” she says.
Reylene says she had to ask several times for ointment.
Instead of sending girls through the same system as boys, Acoca created a health questionnaire to replace the current intake procedure. That way, either a nurse can ask the 132 questions on the Girls Health Screen or a girl can answer them on a computer instead of having to explain an issue in public. While some argue the system takes too long, Acoca said her research shows that poor physical health increases the likelihood that girls would be repeat offenders, so addressing concerns early potentially could help limit recidivism.
Outside of juvenile detention centers, Obamacare has made gains to close the health care gaps between men and women, since insurance companies can no longer charge women more for the same services simply based on their gender. And under the health care reform law, insurance companies must cover a wide range of important preventative health services specific to women — such as contraceptive services, cancer screenings, STI testing and counseling, and annual check-ups — at no additional cost. It is just as important that incarcerated teenage girls also have fair access to health care services that meet their gendered needs.