By Hannah Brown, Health Connected
If you follow current affairs in the U.S., you have probably heard the phrase “unaccompanied immigrant minor” many times over the last few years. The Trump administration’s focus on the issue of immigration has intensified public discourse and left many immigrants feeling uncertain about their future prospects in the United States. At Health Connected, we serve a diverse cross-section of students across the Peninsula and San Francisco Bay Area by delivering in-class instruction on puberty and sex education. I personally have worked with immigrant students at nearly every school that I have visited, including students from Asia, Africa, Polynesia, and Europe. But the greatest number of immigrant youth we interact with come from Mexico and Central America.
Throughout my three years as a health educator at Health Connected, I have had the pleasure of facilitating Spanish-only versions of our Puberty Talk, Teen Talk Middle School and Teen Talk High School curricula, and I also regularly provide extra translations and support to Spanish speakers in majority English-speaking classrooms. Often, when no bilingual programs are available, schools place English Language Learners amongst the general population to immerse students in English, but schools often lack the resources to provide para-educators and translators to support students during their transition. A friend of Health Connected who immigrated from Central America to the Bay Area almost two decades ago shared the frustration he felt during puberty class as a fifth grader, where no Spanish instruction was offered: “I would hear things from classmates regarding sex ed not knowing what was true or false.”
At Health Connected, we believe that it is our duty as educators to deliver a quality, comprehensive sexual health education to all students, because a lack of sex ed can have real-life implications in a young person’s life. Immigrant students are more likely than other young people to experience negative sexual health outcomes, as language and cultural barriers can limit their access to prevention and treatment. For instance, Latino immigrant youth have lower rates of sexual activity and later sexual debuts than non-immigrant youth, but also fewer resources for obtaining quality health care, birth control options and education; they subsequently have higher teen pregnancy rates than white, non-immigrant youth, among other health disparities. In addition, undocumented immigrants may fear the consequences of seeking health services, or may even face legal restrictions on accessing health care. Being aware of these obstacles, as Health Connected educators, we do our best to show immigrant students special care wherever possible, even if we will only be in their classrooms for one or two weeks.
I remember one Redwood City 7th grader who looked a bit dazed when her regular teacher identified her as a recent immigrant who would need translation throughout our two-week Teen Talk course. She is from El Salvador and had only been enrolled in school for about a week when I met her. I introduced myself, explained the basic goals of our course, and encouraged her to ask as many questions as she wanted. She nodded, but I was struck by her solemn look. When I asked her how she was adjusting to her new school, her response was to fill me in on the journey it took her to arrive here. “I lived in a camp for 5 months. I had my 13th birthday there,” she said. My mind flashed to the images I have seen of detention centers on the news, where children are often held indefinitely in federal custody while they wait for placement with extended family or wait to hear the result of an amnesty hearing. And now here my student sat, surrounded by a class full of giggly peers waiting to hear what the “sex ed lady” had to say. It’s hard to fathom the culture shock she must have been experiencing. I could not undo the trauma she had been through (her host teacher assured me that she was working closely with the school psychologist), but during my two weeks as her health educator, I made sure she felt seen and heard as I provided extra translations and support.
At Health Connected, we know how important it is to approach sexual health education using a trauma-informed lens– we never know what students may have experienced before our arrival. Amongst young immigrant populations, the likelihood that one or more of our students have experienced some form of trauma is higher than among the general adolescent population in the U.S. I had the opportunity to witness the way that trauma can shape the tone of an activity during a Spanish-language workshop Health Connected conducted recently with eight unaccompanied immigrant minors, mostly from Guatemala and Honduras, between 15 and 20 years old.
As my co-educator Patricia and I engaged the eight teenagers in some ice breaker activities, we explained that we had been invited to present on the topic of “Healthy Relationships.” We routinely cover romantic relationships in our courses, emphasizing open communication between partners, identifying abusive behaviors, and reaching out to trusted adults for help. Patricia and I knew that this topic would likely be more challenging than usual for our workshop participants, and despite our trigger warnings and pleasant warm-up activities, the mood remained tense. During our discussion about healthy, unhealthy and abusive behaviors, the teens mis-categorized obviously abusive behaviors like “hitting” as merely “unhealthy.” It was clear that students’ life experiences had compromised their expectations for romantic partnerships.
As we moved onto an activity about affirmative consent, however, the tone in the room became much more relaxed. We paired students off, handed each pair a sheet of paper shaped like a puzzle piece and tasked them with brainstorming different ways to ask for sexual consent. Students chatted away as they proposed different questions to gauge a partner’s interest. One student suggested, “Want to go to my room?” as a potential way to ask for permission to get intimate, but another student stopped him. “But what if they misunderstand you? You have to be clearer than that!” Someone else sheepishly suggested, “What about…’Can I caress your hair?’…?” Giggles ensued. In the end, the group created a complete “Consent Puzzle” (pictured to the right). Hopefully, they felt a bit more confident about how to set boundaries and respect others’ in current and future relationships. Allowing them space to express themselves in their own language, in their own vernacular, had a powerful effect on the mood in the room.
As an organization, Health Connected is committed to serving the youth of our communities, regardless of race, class, gender identity, sexual orientation, or immigration status. We feel lucky to count ourselves amongst the many support services that offer immigrant youth the tools for pursuing healthy lives now and in the future. Our students have shown us what incredible resilience in the face of adversity truly looks like, and we strive to continue to learn from our interactions with young people of all backgrounds to improve our curricula and strengthen our organizational mission.
National Latina Institute for Reproductive Health. “Removing Stigma: Towards A Complete Understanding of Young Latina’s Sexual Health.” (July 8, 2014) Retrieved on August 20, 2019 from https://latinainstitute.org/sites/default/files/NLIRH-HPWhite-5310-F2.pdf.
National Coalition of STD Directors. “The Impact of STDs in Different Populations.” (August 4, 2010) Retrieved on August 20, 2019 from http://www.ncsddc.org/resource/the-impact-of-stds-in-different-populations/.
Perreira, Krista M. and India Ornelas. Int Migr Rev, 47(4), (December 2013). “Painful Passages: Traumatic Experiences and Post-Traumatic Stress among Immigrant Latino Adolescents and their Primary Caregivers.” Retreived on August 20, 2017 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3875301/.
This was originally posted on September 9, 2019 on Health Connected’s organizational blog. To see the original posting, visit https://www.health-connected.org/blog.