Girls in closed youth care are sometimes forced to take contraception, showed last week investigation of the journalistic platform pointer† It emerged from conversations with clients and former employees that girls are obliged to use, for example, the pill or an IUD during their treatment. Immediately upon arrival, or as a condition of leave. The institutions deny that there is coercion. What’s the deal?
1 What is going on in youth care?
Pointer spoke with young women who have stayed in closed youth care institutions throughout the Netherlands in recent years. Their stories showed that contraception felt like an obligation to them, because they expected there would be consequences if they refused. “I was young and I couldn’t stand up for myself. You can say that you don’t want it, but then you get pissed,” said one of them. Another: “You’re so used to having things decided for you, that resisting is not an option.”
Children and young people who need protection against themselves or others reside in closed youth care, also called Youth Care Plus. For example, because they are victims of domestic violence or sexual abuse or have fallen into the hands of loverboys. In the institution, they have to deal with restrictive measures laid down in the Youth Act† For example, doors are locked and they are not always allowed to have contact with the outside world. In 2020 there was 1,128 young people referred to as a ‘closed placement’.
2 Is mandatory contraception allowed?
The imposition of contraception is contrary to the right to protection of physical integrity and the right to self-determination, laid down in international treaties such as the European Convention on Human Rights. However, since last year there is a law, the Mandatory Mental Health Care Act, which makes birth control possible in practice. In certain cases, a number of lawsuits have found, contraception can be prescribed as part of the ‘care plan’ for people with mental health problems. However, this must always be tested by a judge first.
Also read this opinion piece by former juvenile judge Cees de Groot: Some women shouldn’t be mothers (2017)
From a strictly legal point of view, youth care institutions are therefore not allowed to simply impose contraception. But what is an obligation? Is there coercion if a client does not explicitly resist? André den Exter, associate professor of health law at Erasmus School of Law, calls this a ‘difficult category’. To Pointer: “It gets a bit shadowy when you push, for example by attaching consequences. From a formal point of view, this is simply a form of coercion, which can only be done with the consent of the judge. Otherwise it is illegal and a violation of bodily integrity.”
3 What do the youth care institutions say?
Youth Care Netherlands made inquiries with all eleven Youth Care Plus institutions. According to the trade association, they do not recognize themselves in the ‘picture’ that Pointer paints. “They indicate that there is no forced contraception in their organizations.” The fact that some young people have experienced the advice to use contraception as an ‘urge’, ‘cannot be ruled out’, of course.
“With us, we never say on arrival: you must use contraception, otherwise it will become annoying,” says Jan van Wirdum, director of the Brabant Youth CarePlus institution Almata. “It is always part of the treatment to make it negotiable. The girls who come to us are often very damaged. Our assignment is: how do you make them resilient?”
In a report from 2018 Regarding Almata’s help to victims of loverboys and human trafficking, the Health and Youth Care Inspectorate notes that contraception can be a condition for leave ‘in case of increased risks’. The times that this actually happened, says Van Wirdum, can be counted on one hand in the past ten years. “The inspector’s comment was based on a situation where a 13-year-old girl with a mild intellectual disability said she was going to have a ‘wild weekend with her boyfriend’. Then we said: let’s postpone the leave for a while.”
Behavioral scientist Lilian Hoogendijk, associated with the Almata girl group, points out the great responsibility of the practitioners. “We are constantly assessing the risks and making the trade-off between self-determination and self-protection.”
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