Turnaway Study Report Unethically Violated Participants' Privacy and Misleads Public with a Non-Representative Sample, Selective Reporting, and Overstated Conclusions.

In a published report of suicidal ideation rates drawn from the Turnaway Study, the abortion advocacy group Advancing New Standards in Reproductive Health (ANSIRH) asserted that their findings proved that abortion has no effect on suicidal ideation. Therefore, laws requiring notification of abortion's link to higher suicide rates were not based on good science. But how good is the science ANSIRH offers to displace the evidence of an abortion-suicide connection? The Turnaway Study upon which they rely is drawn from a non-random, non-representative convenience sample that suffered from a 68% refusal rate and a 50% attrition rate. No conclusions applicable to the general population of aborting women can be drawn from such a sample. Moreover, on closer examination, ANSIRH's suicidal ideation trajectory analysis is severely flawed and violates Strengthening the Reporting of Observational studies in Epidemiology (STROBE) guidelines. Basic and critical information is withheld, specifically the mean scores and number of women identified as having suicidal thoughts. Instead, readers are provided with only highly massaged results from a mixed-effects logistic regression employing thirteen covariates that appear to have been chosen precisely to water down the confidence intervals to such a high degree that virtually nothing was statistically significant. In addition, ANSIRH suggested that an attrition analysis of three of the covariates used strengthened the reliability of their finding. However, the fact that they chose not to report on attrition rates associated with the other ten covariates, much less the two outcome variables related to suicidal ideation, actually exposes the falsity of this reliability claim. Rather than proving that abortion has no effect on suicidal behaviors, ANSRIH's published analysis provides evidence of deliberate obfuscation and disinformation by a group funded and dedicated to the expansion of abortion rates around the world.

The abortion advocacy group Advancing New Standards in Reproductive Health (ANSIRH) has published over twenty papers based on a case series of women taking part in their Turnaway Study. Following the lead of ANSIRH news releases, major media outlets have described these results as proof that (a) most women who have abortions are glad they did, (b) there is no evidence of negative mental health effects following abortion, and (c) the only women really suffering are those who are being denied late-term abortions due to legal restrictions based on gestational age. Buried in ANSIRH's papers are the facts that over 68 percent of the women they sought to interview refused, their own evidence confirms that the remnant who did participate were atypical, there are no known benefits from abortion, their methods are misleadingly described, and their results are selectively reported. Summary: Widely publicized claims regarding the benefits of abortion for women have been discredited. The Turnaway Study, conducted by abortion advocates at thirty abortion clinics, reportedly proves that 95 percent of women have no regrets about their abortions and that abortion causes no mental health problems. But a new exposé reveals that the authors have misled the public, using an unrepresentative, highly biased sample and misleading questions. In fact, over two-thirds of the women approached at the abortion clinics refused to be interviewed, and half of those who agreed dropped out. Refusers and dropouts are known to have more postabortion problems.

Objective: Maya women in Guatemala are disproportionately affected by poverty and negative reproductive health outcomes. Although social networks are valued in many Indigenous cultures, few studies have explored whether health education programmes can leverage these networks to improve reproductive health and economic wellbeing. Design: This qualitative study explored the role that social networks play in both health education and economic empowerment among women involved in a Maya reproductive health women’s group. Setting: Western highlands region of Guatemala. Method: Semi-structured in-depth interviews, each lasting 2–3 hours, were conducted with 19 women (aged 18–40 years) who had participated in a formal women’s network. Topics addressed included personal experience with the group, aspirations for the future and attitudes towards reproductive health and economic wellbeing. Results: Respondents stated that by engaging in formal group activities and interacting with others in the network, they were able to find their voice. They described gaining self-confidence needed to speak about reproductive health with pre-adolescent and adolescent girls as well as other community members. Respondents also discussed learning new ideas/skills and detailed future aspirations of planning their family and reaching educational/career goals. Conclusion: The study illustrates the potential of social networks to provide individuals with knowledge and skills, along with new ways of thinking about themselves and their futures. Health education programmes aspiring to improve the reproductive health and economic wellbeing of vulnerable groups, such as Maya women, should seek to leverage the benefits of such social networks.

30 Years of Women's Health Issues

Objectives Sexual health remain a significant challenge in rural Indonesia, driven by limited access to education, health, logistics, communication, and the lack of public policies in prioritizing sexual health. To see the multifaceted challenges, a holistic approach to sexual and reproductive health is a key strategy for improving sexual health and well-being. This systematic review aims to explore all research on sexual health and sexual well-being in rural Indonesia so that it can provide a comprehensive picture of the conditions and challenges faced by rural communities related to these aspects. Method The study retrieved relevant literature from the Scopus database following the PRISMA guidelines with Watase Uake Tools. A total of 124 studies were identified, with 28 studies meeting the inclusion and exclusion criteria. The review spans a decade of research from 2015 to 2025, incorporating multidisciplinary perspectives across psychology, health, public policy, and sociology. Results This systematic literature review groups several sexual health problems that occur in rural Indonesia, such as early marriage, multiple marriages, sexual harassment, premarital sex, risky sexual behavior, sexual violence, sexually transmitted infections (STIs), HIV/AIDS, sexual dysfunction, gender inequality, reproductive health, sexual well-being, pornography use, and sexual health education with policy about sexual health in indonesia such as HPV vaccine in Indonesia, sexual and reproductive health education, early marriage in Indonesia, sexual violence in Indonesia. Conclusion With the information obtained, researchers, scientists, and practitioners working on sexual health issues can better understand the specific dynamics that affect rural communities. This includes understanding the cultural, social, and economic factors that influence sexual health and assessing the effectiveness of various interventions that have been implemented.

A blueprint for a new model of sexual and reproductive health care in subspecialty medicine.

BACKGROUND Adolescent sexual and reproductive health constitutes a critical component of the right to the highest attainable standard of physical and mental health for all[1].However, adolescent sexual and reproductive health rights (ASRHR) are currently faced with severe challenges[2], According to reports by Together for Girls, 82 million girls and 69 million boys experienced some form of child sexual violence in 2024[3];the World Health Organization (WHO) reported that approximately 190 million individuals (25%) may experience physical or sexual violence from intimate partners before the age of 20[4]. Adolescents often seek sexual health-related assistance through question texts on internet platforms[5],rendering the mining of user-generated texts by adolescents a proactive role in the prevention and intervention of adolescent sexual violence. Nevertheless, as the first step in mining, classifying sexual health information remains difficult for existing general models to address effectively due to the complex semantics[6]and elusiveness[7] of sex-related information, thus creating an urgent need for the construction of a targeted specialized model. Text classification in the field of natural language processing (NLP) enables the organization of large volumes of unstructured text data into specific categories, providing technical support for identifying sexual health needs. The evolution of text classification systems has advanced from information retrieval[8-10], [11], [12, 13], recommendation systems [14], sentiment analysis [15, 16], and public opinion analysis [17].Pre-trained models (PTMs) [18] to information filtering[11],text categorization[12, 13],recommendation systems [14],sentiment analysis[15, 16], and public opinion analysis[17]. PTMs[18] a further advancement in text classification, have developed from word embeddings to contextual encoders, addressing the challenges of deep learning models that require large-scale data to prevent overfitting due to their numerous parameters[19].Unlike traditional unidirectional models that capture text information solely from left-to-right or right-to-left, Bert-based[20] PTMs employ bidirectional training, enabling simultaneous consideration of contextual information from both sentence directions and more accurate and comprehensive semantic understanding of vocabulary. In the realm of sexual health information, classifying related texts carries significant implications. GM Barrientos et al.[6] utilized machine learning techniques to categorize pornographic/sexual content questions online, aiming to protect children from harm. TT Nguyen et al.[21] applied large language models (LLMs) to identify sexual predators in online discussions and comments, contributing to a safer internet environment. N Potha et al.[22] used data mining techniques on online platforms to recognize instances of sexual violence and abuse against adolescents, thereby safeguarding ASRHR. These examples demonstrate that deep learning and other technologies can be leveraged to achieve the goal of protecting ASRHR. Although text classification technologies have made progress in the medical and health field, numerous challenges persist. For instance, sexual health information from diverse sources varies significantly in language expression and professional complexity, which existing classification models struggle to fully adapt to[23] . Additionally, the unique needs and psychological characteristics of adolescents have not been adequately considered[24].Therefore, this study aims to propose a specialized model for binary classification of adolescents’ online consultation data and question texts to identify online inquiries related to sexual health (OISH), providing model and data support for subsequent research. This approach not only enhances the efficiency and accuracy of screening sexual health information but also assists healthcare workers and educators in promptly identifying adolescents’ sexual health issues, thereby promoting their physical and mental well-being. OBJECTIVE Globally, sexual violence against adolescents occurs frequently, and their adolescent sexual and reproductive health rights (ASRHR) face significant challenges. METHODS Consultation data and question texts were crawled from "Xunyi Wenyao" and "Youwen Bida" using the "Octopus" crawler program. After data processing, domain experts were invited to participate in manual annotation. Multiple pre-trained models (PTMs) were trained, and following performance evaluation, a model was constructed by integrating a voting mechanism. Performance evaluations were conducted on both the training dataset and the adolescent dataset. RESULTS OSIH-BERT integrates ERNIE 3.0, rbt6, and Bert-base-chinese through a voting mechanism. Compared with a single PTM, this model has approximately a 2% performance improvement. CONCLUSIONS This model demonstrates high accuracy and discriminative ability in the classification task of adolescent sexual and reproductive health-related online inquiries (OSIH). It can be used to classify adolescents' questions and requests regarding sexual health, providing technical support for the protection of ASRHR. CLINICALTRIAL none

Sexual and reproductive health and rights are basic human rights: The FLASOG Panama Declaration and FIGO Cartagena Declaration.

An Italian projects for sexual health rights: AIDASS (Italian Association for Sexual Health Rights)

Transgender and gender diverse (TGD) persons face considerable challenges accessing sexual and reproductive health care (SRHC), often resulting in poor health outcomes when compared to cisgender persons. Aetiological research predominantly explains these health disparities through a single axis explanation reducing them to factors related to gender identity. Yet, a one-dimensional representation of TGD persons fails to recognize the multiple experiences of systemic oppression that may contribute to poor sexual and reproductive health (SRH) experiences and outcomes. This scoping review was conducted to locate, analyse and synthesise contemporary scientific research exploring TGD persons’ experiences with SRHC services, from an intersectional perspective. Searches were conducted in PsycINFO, APA Psychinfo, Ovid MEDLINE®, SCOPUS, and CINAHL. Studies were included if they were in English, conducted in OECD countries, published between 2012 to 2022 in peer-reviewed journals, based upon empirical research, involving human participants and presenting disaggregated data for TGD populations. To be included, studies also had to contain TGD individuals who had accessed SRHC services and data that pertained to forms of oppression, disadvantage, social determinants of health or aspects of identity that intersected with their gender identities. 1290 records were identified and entered into Endnote software X9, with 413 removed before screening. A total of 877 records were screened by the author and a research assistant independently who examined titles and abstracts and selected 27 for in-depth analysis. Included studies were uploaded to NVivo 12 and subjected to in-depth review, coding, and synthesis using descriptive statistics and thematic analysis. The review found that efforts to understand TGD persons’ experiences of multiple marginalisation in SRHC settings are hampered by methodological challenges relating to adopted sampling techniques, measures used, the use of small and non-representative samples, and geographic location. The review found multiple intersecting systems of oppression including cissexism, heterosexism, racism, classism, geographical disadvantage and ageism, that challenged TGD persons’ access to quality care within SRHC settings. Best practices were identified including affirming, person-centred care, collaboration, trauma-informed care and leveraging informal support networks, which provide hope for improved service provision and design.

The aim of this paper is to explore the importance of sexual health promotion to the emotional wellbeing of older people and to outline the principles of an organisational approach to sexual health promotion. Strategies to improve the emotional wellbeing of older people seldom consider the links between sexual health and wellbeing. This is because older people are generally considered to be asexual and the term ‘sexual health’ often conjures up images of preventing sexual transmissible infections in young people. However, a definition of sexuality and sexual health developed by the World Health Organisation demonstrates the link between sexual health and overall wellbeing throughout life. The association is demonstrated in a number studies presented that explore the impact of sexual activity on stress, mental health and quality of life. This evidence has been incorporated into the principles for sexual health promotion developed by the World Health Organisation and is presented as a checklist for organisations to audit the extent to which they promote the sexual health of older clients.

Implementing a Prospective Study of Women Seeking Abortion in the United States: Understanding and Overcoming Barriers to Recruitment

Poor reproductive health among youth and adolescents threatens their future health and economic wellbeing in Zimbabwe amidst a high HIV/AIDS prevalence. This study evaluates the impact of a multi-pronged adolescent sexual and reproductive health (ASRH) strategy implemented by government of Zimbabwe between 2010 and 2015 to improve ASRH in terms of the uptake of condoms and HIV testing as well as outcomes in terms of sexually transmitted infection (STI) prevalence and HIV prevalence. We combine the difference in difference and propensity score matching methods to analyse repeated Zimbabwe demographic health survey cross-sectional datasets. Young people aged 15–19 years at baseline in 2010, who were exposed for the entire five-year strategy are designated as the treatment group and young adults aged 25–29 at baseline as the control. We find that the ASRH strategy increased HIV testing amongst youth by 36.6 percent, whilst treatment of STIs also increased by 30.4 percent. We also find that the HIV prevalence trajectory was reduced by 0.7 percent. We do not find evidence of impact on condom use and STI prevalence. The findings also suggest that although HIV testing increased for all socio-economic groups that were investigated, the effect was not the same. Lastly, we do not find evidence supporting that more resources translate to better ASRH outcomes. We recommend designing future ASRH strategies in a way that differentiates service delivery for youths in HIV hotspots, rural areas and out of school. We also recommend improving the strategy’s coordination and monitoring, as well as aligning and enforcing government policies that promote sexual and reproductive health rights.

The authors are staff members of the World Health Organization. The authors alone are responsible for the views expressed in this chapter and they do not necessarily represent the decisions or policies of the World Health Organization. Addressing the sexual and reproductive health needs and problems of adolescents is a crucial element of the World Health Organization (WHO) Global Reproductive Health Strategy. In many parts of the world, the sexual and reproductive health needs of adolescents are either poorly understood or not fully appreciated. Evidence is growing that this neglect can seriously jeopardize the health and future well-being of young people. Sexual activity during adolescence (within or outside marriage) puts adolescents at risk of sexual and reproductive health problems if they do not have access to the needed information, education and services. These problems include early pregnancy (intended or otherwise), unsafe abortion, sexually transmitted infections (STIs) including human immunodeficiency virus (HIV), and sexual coercion and violence. In addition, in some cultures, girls face genital mutilation and its consequences. This chapter looks at the sexual and reproductive health issues related to adolescent pregnancy from the point of view of the continuum of care. The continuum of care is an approach promoted by WHO and in the context of reproductive, maternal, newborn, and child health (RMNCH). This continuum of care includes integrated service delivery from pre-pregnancy to delivery, the immediate postnatal period, and childhood. In the context of adolescent pregnancy, the continuum of care means that provisions should be made to ensure access and quality services before the pregnancy (such as interventions to improve nutritional status and health to reduce the likelihood of health problems in the mother and baby), during the pregnancy (antenatal, intra- and immediate postnatal care, as well as safe abortion and post-abortion care), and after the delivery to ensure proper care for the adolescent mother and her baby. The care for pregnant adolescents, thus, is a joint responsibility of families, communities, health sector as well as other sectors. It is a person-centered care that involves adolescents in its design, planning, and monitoring and understands holistically their physical, emotional, and social concerns.

Globalization and digitalization give rise to a complex of problems of economics, sociology, and occupational health. The prevalence of precarious employment (PE) is growing. In connection with the COVID-19 pandemic and the economic crisis, employment and social well-being have become acute. The study aims to review literature and essays on PE as a problem of occupational health and a new social determinant of workers' health. The author has made the analysis of documents from WHO, ILO, European Union, etc., scientific literature and essays on the problem of PE and its impact on somatic (including reproductive) health, mental health, and workers' social well-being. The legal bases of labor and health protection are considered. The informal economy, the terminology of forms of PE, and the ILO Convention No. 175 on part-time work and the Convention No. 177 on home work and the Decent Work Initiative were analyzed. The characteristics and prevalence of PE, examples of forms of work organization, affected groups of the population, and sectors of the economy are considered. Vulnerable groups are women (especially pregnant women), young and elderly workers, migrants, and the most unfavorable situation is in construction, agriculture, catering, tourism, etc., and much better in the public sector. PE and its impact on health are an essential topic in social epidemiology, and affective health problems are almost as severe as unemployment. PE is often associated with poor working conditions, physically demanding work and an increased risk of accidents, with young workers more often affected. The lack of confidence in keeping a job negatively affects mental health - the odds ratio is over 1.5. PE is associated with impaired reproductive behavior and reproductive health and the birth of children with low body weight. The features of home work, its pros, and cons are given. An analysis of employment from the standpoint of occupational health revealed the relationship between forms of employment and indicators of health and quality of life and made it possible to complete some generalizations and formulate the principles of work and health. The future of labor, new occupations, knowledge, and skills are considered. In the United Nations Development Program, Goal 8, Decent Work and Economic Growth, is to achieve full employment and decent work for all by 2030. PE is becoming more frequent; therefore, further data collection and research into its effects among new groups of workers is necessary. Soon, the digitalization of the economy and society will cause a paradigm shift in occupational health: the future of occupational health is the prevention of occupational diseases and work-related disorders.