Submission to the House of Commons Committee on Health: Study on Children’s Health

Submitted by Action Canada for Sexual Health and Rights. June 11, 2022.

Action Canada for Sexual Health and Rights (“Action Canada”) is a registered Canadian charity that works in Canada and around the world to promote health, well-being, and rights related to sexuality and reproduction. Building on the 50-year legacy of the organizations that formed Action Canada[1] , we provide direct support, referrals, and information to the people who need it most, partner with groups and organizations on a range of campaigns using a collaborative, movement-building approach, and work with decision-makers to advance progressive policies on access to abortion, stigma-free healthcare, gender equality, 2SLGBTQ+ rights, and inclusive sex-ed.

Our vision is for all people everywhere to have full control over, and to decide freely upon, all matters related to their sexuality, reproduction, and gender, including their reproductive and sexual health. Action Canada places human rights and dignity at the centre of its work and strives to consider and addresses the diverse needs and intersectional circumstances of different communities. 

 It is through this lens that we are addressing the issue of sexual and reproductive health and rights as it pertains to children’s health.

The Situation

The ongoing pandemic has impacted access to sexual and reproductive health and rights for children and adolescents across Canada. There has been a weakening of existing sexual health provisions which has in turn caused an increase in STBBI rates and a decrease in access to a range of services and information for young people.

Access to comprehensive sexuality education (CSE) has been weakened given ongoing schooling disruptions since March 2020.  Over the last two years, students and educators have had to adapt to constantly evolving public health instructions including the restriction on external visitors, long periods of school closures with students learning online, often with little to no privacy at home, staff shortages due to sickness, student absenteeism and, overall, mounting pressure on school systems already stretched beyond their limits.  

With regards to health services, many community-based sexual health centres were forced to close during the pandemic or to restrict services to only those designated as essential or because of shortages of staff and resources as demand rose.  Community-based sexual health centres are a critical point of access for children and adolescents as they provide confidential, youth-friendly information and services, including access to contraceptives. To get a holistic view of children’s health, it is important to take into account sexual and reproductive health. The recommendations outlined in this brief could significantly improve access to sexual and reproductive care for children and adolescents in Canada and allow youth to take a more active role in decisions around their own care.

Recommendation 1: Provide Universal Access to Contraceptives

Many Canadian youth are unable to afford the medicine and devices they need to support their sexual and reproductive health. The ability to manage your own contraceptive care should not depend on private or patchwork insurance coverage.

As it exists, Canadians experience differential access to medications depending on the province or territory in which they live, and the forms of public and private insurance available.

Many national health organizations, including the Canadian Pediatric Society, have flagged that contraceptive care providers have specified that cost of contraceptives is a significant barrier to access for youth and impacts whether they will use them or not. Adolescents in Canada have also expressed concerns over accessing confidential contraceptive care as a concern along with the ability to afford it.  Studies in BC show that nearly 60% of women in the region aged 15-19 do not use any contraception at all.

Access to contraception is key to the right to health, achieving gender equality and women’s empowerment, realizing public health goals and reducing health care costs. A recent recommendation by the UN Committee on the Rights of the Child suggests that Canada should “strengthen sexual and reproductive health programmes and services to all adolescents, paying particular attention to prevention of unwanted pregnancies, support to pregnant girls and adolescent parents and to reduce the risk of sexually transmitted infections.”

The Government of Canada needs to urgently implement a National Pharmacare Strategy that covers the cost of all forms of contraceptives for everyone in Canada.

Recommendation 2: Federal Leadership on Comprehensive Sexuality Education

Comprehensive Sexuality Education (CSE) is a globally recognized human right and upstream public health intervention. There are international gold standards guiding curriculum content and delivery based on strong scientific evidence. Despite evidence that demonstrates the crucial importance of comprehensive sex-ed to achieving better health and social outcomes for young people, the state of comprehensive sex-ed in Canada remains dismal.

In 2020, Action Canada published its report ‘The State of Sex-ed in Canada’ after reviewing and analyzing all provincial and territorial sex-ed curricula. With support from local partner organizations across provinces, Action Canada hosted consultations and focus groups to speak to young people about their experiences of sex-ed in six cities. We also sought out teachers and sexual health educators from different communities to better understand the context in which they must do their work and to what is taking place in Canadian classrooms. Our findings mirrored other Canadian studies on the topic – the Government of Canada has failed to hold provinces and territories accountable for the delivery of comprehensive, quality, evidence-based sexuality education, in line with national guidelines for sexual health education and international human rights obligations despite its duty and responsibility to uphold and advance human rights. 

In 2019, the Canadian guidelines for sexual health education by Sex Information and Education Council of Canada (SIECCAN), endorsed by the Public Health Agency of Canada, were re-released. They are meant to guide educators and policy makers when it comes to comprehensive sexuality education in Canada. In 2022, it is still the case that the Government of Canada has not taken any steps to standardize sex-ed across provinces and territories or to even disseminate or raise awareness to the existence of the 2019 Canadian guidelines for Sexual Health Education, nor has it engaged provinces and territories towards strengthening the quality or implementation of CSE across jurisdictions in line with human rights obligations. 

The Federal Government has repeatedly shirked responsibility for implementing its human rights obligations concerning CSE, stating the division of power between federal and provincial jurisdictions as reason for refusing to take a leadership role. This is made evident by the absence of any mention of comprehensive sexuality education in both its 2021 and 2022 Federal Budget, with no investment made to ensure the capacity for provinces and territories to comply with the 2019 Canadian Guidelines on Sexuality Education. Similarly, Comprehensive Sexuality Education was not mentioned in Federal Electoral Platforms or any of the Mandate letters penned following the election of the current government, elected in 2021 despite how many states from all regions of the world have recognized the transformative impact of comprehensive sexuality education and have taken political, financial, and policy steps to ensure that children and young people have access to high quality and scientifically accurate comprehensive sexuality education within their jurisdictions.

The lack of federal action in this area is concerning given that some provinces have taken active steps to deny young people access to comprehensive sexuality education.

Canada has also received recommendations from multiple national organizations and United Nations (UN) treaty bodies including, most recently, from the UN Committee on the Rights of the Child that the federal government needs to “take immediate measures to ensure equal access to evidence-based comprehensive sexuality education across provinces and territories in line with national guidelines for sexual health education and international human rights obligations”.

Sex-ed must become a national priority. In collaboration with civil society, youth-led organizations, young people, and experts, Canada has responsibility to provide adequate financial and human resources to the Public Health Agency of Canada and the Women and Gender Equality ministry to promote the full implementation of the Canadian Guidelines for Sexual Health Education and the integration of recommendations on Comprehensive Sexuality Education in Canada’s National Action Plan on Gender-Based Violence. 

Recommendation 3: Strengthen Equitable Access to Sexual Health Services

Existing inequalities experienced by children and adolescents in Canada have been exacerbated by the COVID-19 pandemic, particularly in respect to access to sexual health services.  Community-based sexual health centres are a critical point of access for children and adolescents as they provide confidential, youth-friendly information and services. It is crucial that, despite the increased demands on health systems, children and youth are not denied access to health services, including sexual and reproductive health services. Canada must respect the right to non-discrimination through its measures to address COVID-19 and ensure the rights of children and adolescents to sexual and reproductive health are respected, protected, and fulfilled including and especially during times of crises.

Sexually transmitted blood-borne illness (STBBI) testing, treatment and prevention campaigns were also deprioritized during the pandemic resulting in a dramatic increase in STBBI rates across the country. In order for Canada’s action plan for reducing the health impacts of STBBIs by 2030 to be effective, the government must recognize the importance of providing equitable access to sexual and reproductive health services for youth across the country.

[1] Action Canada is a legal amalgamation of the Canadian Federation for Sexual Health (formerly the Planned Parenthood Federation of Canada), Canadians for Choice, and Action Canada for Population and Development

Posted on 2022-07-13
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