COVID Won’t Stop Young People From Having Sex. Let’s Get Them the Health Care They Need.

Laura D. Lindberg, Rutgers School of Public Health
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Originally published in Ms. Magazine.

For the first time since the Great Depression, the majority of young adults live with one or both parents due to the COVID-19 crisis. The pandemic is contributing to major shifts in young people’s lives—but one thing COVID-19 is not likely to change is that young people will still have sex.

This struck me this past spring, when college campuses closed and my freshman son and his friends went back home. Here, I saw him texting with his female friend, advising her that she could go to Planned Parenthood because she could no longer go to their college health center—her usual provider—for confidential care.

Even in the midst of a pandemic and recommended social distancing, we can’t pretend that college students and other young adults aren’t having sex. They are, and they need access to contraception, abortion, STI testing and treatment, and comprehensive sex education. 

About two-thirds of 18-year-olds and nearly 90 percent of 25-year-olds report ever having sex—something the pandemic is not likely to stop. Months of social distancing won’t dull young people’s basic human need for social and physical connection.

As if COVID-19 wasn’t enough to worry about, in a national survey in May, more than one-third of 18- to 24-year-old women expressed worry they wouldn’t be able to access contraception or other sexual and reproductive health care because of the pandemic. 

Young adults are facing unique health challenges due to COVID-19, regardless of whether they are in college or where they are living (in a college dorm, with their parents, or elsewhere).  The pandemic has disrupted normal living arrangements and brought an unprecedented number of young people back to their childhood bedrooms.

In July, 26.6 million young adults were living with their parents. This living in close quarters can mean more parental monitoring and less privacy. Such arrangements may result in a compromised ability to get needed confidential health care

This is particularly true for sexual and reproductive health care. Even in the age of telehealth, it’s not realistic to assume that teens and young adults can always have a candid conversation with their doctor when living with family—especially about birth control, STI testing or abortion care.

Like my son’s friend, many young people who can’t be physically at school may not even know where to get sexual and reproductive healthcare if they can’t go to their college health center. 

How to Provide Young Adults With Essential Sexual and Reproductive Health Care

Like it has done with so many economic, social and healthcare inequities, COVID-19 has put a spotlight on how difficult it can be for teens and young adults to get the quality sexual and reproductive health care they deserve. State and federal policymakers can take concrete steps now to address young people’s needs and safeguard them for the future.

Expanding access to telehealth can help young people get the care they need, especially since this generation are "digital natives" who are skilled and comfortable online—nearly half say they are online almost "constantly." 

But telehealth expansion efforts need to ensure that access to remote health care is equitable and affordable, including in rural areas where broadband is weak or for young people without expensive data plans. We can make it easier for college-age young people to order contraception, medication abortion, STI testing and other health care remotely for home or school mail delivery. 

It remains critical that young people have insurance coverage for their sexual and reproductive health needs.

Allowing young adults to be on their parents’ health insurance until age 26 has made a huge difference, but concerns about keeping their health care use private (and not have detailed paperwork like explanation of benefits sent home to mom or dad) can be a deterrent. We must continue to fight for the integrity of the Affordable Care Act and its robust coverage of contraception, HPV vaccinations and other preventive services, as well as for critical programs like Medicaid and the Title X national family planning program that make such care affordable and more available.  

For young people most in need, public family planning clinics are an important resource. 

In the 2011–2015 period, more than one‐fourth of young women and teenage girls who received contraceptive care went to a publicly funded clinic. 

But these clinics face political and ideological threats designed to weaken them and many have closed or lost crucial funding. There is an urgent need to boost funding for the Title X national family planning program and get rid of harmful restrictions imposed on it by the Trump administration. This is imperative to help meet increased demand as young people lose their own or their parents’ employer-sponsored insurance, making care at private providers unaffordable.

Fortunately for my son’s friend, he was able to give her good advice on where to get quality, confidential care during the COVID-19 crisis. But it shouldn’t have to be this way: Teens and young adults shouldn’t have to scramble to meet their sexual health needs. The COVID-19 crisis or living with their parents will not stop young people from having sex. We must act now to make sure they can get essential sexual and reproductive health care during this pandemic and beyond.   

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