The Centers for Disease Control (CDC) released its Youth Risk Behavior Survey Data Summary & Trends Report: 2011-2021 just weeks ago revealing increased rates of sexual violence experienced among teen girls and teens who identify as lesbian, gay, bisexual, and questioning (LGBQ+) from 2011 to 2021. The survey indicated that almost one in five teen girls experienced sexual violence in the past year—a significant increase from 2017– and nearly one in four LGBQ+ students experienced sexual violence.¹

Though the survey did not provide the specificity around what relationship the aggressor of the sexual violence had to the victim, we do know from other research that in many cases of sexual violence against teens, the aggressor is a dating partner.  Studies show that each year in the U.S., at least 400,000 adolescents experience serious physical and/or sexual dating violence.²  Data from CDC’s Youth Risk Behavior Survey in 2019 indicate that among U.S. high school students who reported dating during the 12 months before the survey, about one in 12 experienced sexual dating violence, with higher rates for female students compared to male students and higher rates for LGBTQ students, or those who were unsure of their gender identity, compared to students who identified as heterosexual.³

While the CDC urges schools to have a proactive health care response to these increased rates of sexual violence and other health concerns—”Increasing access to needed health services,” and “Implementing quality health education,”– it is an opportunity for health care agencies to follow suit.¹

Health care agencies are in the best position to respond to intimate partner violence, teen dating violence, and adolescence relationship abuse (ARA), as health care professionals are coming into contact with victims frequently. One study found that two in five female adolescent patients seen at urban adolescent clinics had experienced intimate partner violence and 21% reported sexual victimization.⁴ Health care professionals may be able to determine red flags for abuse; for instance, the presence of mental health issues such as depression, thoughts of suicide, substance abuse and disordered eating may be clinical indicators to assess for ARA.⁵ Even if abuse is not identified through screening, there are also opportunities within health care settings to offer universal education on healthy relationships, potential signs of abuse, and available resources and support.⁶

Furthermore, health care agencies are able to provide care and intervention for other adverse health impacts of abuse and sexual violence. In addition to physical injury, ARA is closely linked to many adverse health outcomes including poor mental health, substance use, poor reproductive and sexual health, risky social behavior, and even homicide. Population-based data indicates that teens who experienced forced sexual intercourse were more likely to engage in binge drinking and attempt suicide.⁵

Screening is also a recommendation of many national organizations. The Women’s Preventive Services Initiative (WPSI), a federally-supported collaborative program, led by The American College of Obstetricians and Gynecologists (ACOG), recommends screening adolescents for interpersonal and domestic violence, at least annually, and, when needed, providing or referring for initial intervention services such as  counseling, education, harm reduction strategies, and referral to appropriate supportive services.⁷ Futures Without Violence outlines other considerations in its Hanging Out or Hooking Up: Clinical Guidelines on Responding to Adolescent Relationship Abuse.⁸

By screening and assessing for abuse, educating victims about their options, and referring patients to IPV service providers, the health care community can create life-saving options for survivors. At the Maryland Health Care Coalition Against Domestic Violence, we can provide further training, technical assistance, and materials for health care professionals trying to create this effective and proactive response. For more information on how to begin making a difference in the lived lives of victims, health care professionals can go to our website at www.healthanddv.org.

References

1. Centers for Disease Control and Prevention. (2023, March 9). CDC report shows concerning increases in sadness and exposure to violence among teen girls and LGBQ+ Youth. Centers for Disease Control and Prevention. https://www.cdc.gov/nchhstp/newsroom/fact-sheets/healthy-youth/sadness-and-violence-among-teen-girls-and-LGBQ-youth-factsheet.html?fbclid=IwAR3KImDdAJ54WcQpOTzzSNUJ-2bUG-_A90AOCMOWMdoBX1OEwJgz7VzRoMs

2. Wolitzky-Taylor KB, Ruggiero KJ, Danielson CK, Resnick HS, Hanson RF, Smith DW, Saunders BE, Kilpatrick DG. Prevalence and Correlates of Dating Violence in a National Sample of Adolescents. Journal of American Academy of Child and Adolescent Psychiatry. 2008; 47(7):755-762.

3. Centers for Disease Control and Prevention. (2023, January 27). Fast facts: Preventing teen dating violence |violence prevention|injury Center|CDC. Centers for Disease Control and Prevention. https://www.cdc.gov/violenceprevention/intimatepartnerviolence/teendatingviolence/fastfact.html

4. Miller E, Decker MR, Raj A, Reed E, Marable D, Silverman JG. Intimate Partner Violence and Health Careseeking Patterns among Female Users of Urban Adolescent Clinics. Maternal and Child Health Journal. 2010 Nov; 14(6):910-917.

5. Behnken MP, Le YC, Temple JR, Berenson AB. Forced sexual intercourse, suicidality, and binge drinking among adolescent girls. Addictive Behaviors. 2010;35(5):507-509.

6. Holditch Niolon, P., Kearns, M., Dills, J., Rambo, K., Irving, S., Armstead, T. L., & Leah Gilbert. (2017). (rep.). Preventing Intimate Partner Violence Across the Lifespan: A Technical Package of Programs, Policies, and Practices (p. 37). Atlanta, GA: Division of Violence Prevention National Center for Injury Prevention and Control Centers for Disease Control and Prevention. https://www.cdc.gov/violenceprevention/pdf/ipv-technicalpackages.pdf

7. Women’s Preventive Services Initiative (WPSI). (2016). Evidence Summary: Screening for Interpersonal and Domestic Violence https://149858107.v2.pressablecdn.com/wp-content/uploads/Interpersonal-and-Domestic-Violence.pdf

8. Chamberlain, L., Newlan, S., Kirkpatrick, R., &; Duplessis, V. (2013). Hanging Out or Hooking Up: Clinical Guidelines on Responding to Adolescent Relationship Abuse (Second). Futures Without Violence. https://www.futureswithoutviolence.org/hanging-out-or-hooking-up-clinical-guidelines-on-responding-to-adolescent-relationship-abuse-an-integrated-approach-to-prevention-and-intervention/