This review examines issues surrounding sexual health in adolescent and young adult (AYA) males and highlights gaps in care and the need for more sexual education in this population. Studies show that use of sexual and reproductive health care services by young males is low, for a variety of reasons. Principal among these is the fact that the components of young men’s sexual and reproductive health care have been poorly defined and have historically received little attention.
In addition, data show that primary care providers are 3 times more likely to take sexual health histories from female patients than male patients and twice as likely to counsel female patients on the use of condoms. Finally, sexually transmitted infections (STIs) are more likely to be asymptomatic among males. As evidenced by the data and findings of a number of organizations, adolescent and young adult (AYA) males are largely invisible to our health care system. Traditionally, prevention and intervention for mental health disorders among adolescents and young adults has been largely non-gender specific. To the extent that these types of measures have been gender specific they have focused on conditions among AYA females, which, in turn, have been considered the norm for both genders. Recently, however, research into mental health disorders has identified a number of conditions that are more common, or expressed differently, among AYA males than among AYA females.[1] One example of how a mental health condition is expressed differently by gender is depression. Whereas, among AYA females, depression is typically manifested by “internalization”, among AYA males it is manifested by “externalization”; that is, among AYA females depression is often expressed through, for example, self-doubt and withdrawal, whereas among AYA males depression is often expressed through, for example, risky behaviors and violence. Further, certain behaviors that are indicators of mental health disorders among AYA males, as distinguished from AYA females, are elevated rates of suicide, conduct disorder, substance use and interpersonal violence.[2] Additionally, norms of masculinity can lead to complicating factors such as stigma among AYA males surrounding help-seeking behaviors for mental health disorders. In terms of suicide alone, among youth ages 15-24, young males complete suicide at a rate that is four times that of young females.[3] Given these differences, many mental health prevention and intervention strategies and modalities could be more successful if tailored by gender. In response to evidence of unrecognized depression among AYA males, The Partnership for Male Youth has launched a groundbreaking effort to focus on this important topic. That effort consists of two parts: a report on research and recommendations on the subject and the December 2020 webcast which also focuses on the subject. The State of Health of Adolescent and Young Adult Males in the United States – Unrecognized Depression: A Review of Research and Recommendations, is found above. The webcast that reviewed the report can be viewed here. [1] Adolescent and Young Adult Male Mental Health: Transforming System Failures Into Proactive Models of Engagement. Rice, Simon M. et al, M.Psych (Clin), Ph.D et al. Journal of Adolescent Health 62. 2018. [2] Ibid. [3] Suicide Rates Among Adolescents and Young Adults in the United States, 2000-2017. Miron, MA et al. Journal of the American Medical Association. 2019. |