Guide to Reproductive Health Care in College

Reproductive health care is often discussed in relation to female health, but it's highly important for both sexes. The World Health Organization defines reproductive health as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes."

This state of well-being means everyone should be able to have a safe and healthy sex life, both physically and emotionally. It also implies people can choose if and when they want to do so. The ability to have safe sex means avoiding sexually transmitted infections, unintended or unwanted pregnancy, and engaging in consensual sexual activities.

Reproductive health care isn't just a women's issue or something straight couples need to consider. Avoiding sexually transmitted infections and engaging in consensual sex is important for everyone, including men, trans people, same-sex partners, people in long-term monogamous relationships, and even those who are infrequently sexually active or only engage in oral sex.

Contraception

Access to a variety of contraceptives is one of the most important components of reproductive health. They help prevent pregnancy, and some, like condoms, protect you from herpes, HIV, and other STIs.

Planned Parenthood offers comprehensive guides on different types of birth control and contraceptives, and on emergency contraception and how to access it quickly. Healthline also provides a guide on safe sex for LGBTQIA+ people, although this resource is also highly useful for any college student. The Healthline guide includes explanations on how to use male and female condoms, dental dams, and gloves or finger cots to have safer sex.

STI Testing and Prevention

We covered the importance of condoms, dental dams, and other barriers in the contraceptives section. However, another crucial piece of reproductive health is preventing sexually transmitted infections. While condoms and other barrier methods do protect you, one of the most important things you can do is get tested and have your partner get tested.

Getting tested for STIs regularly is critical for sexually active people with more than one partner or those who are having unprotected sex. Having honest conversations about who else you're having sex with and how often you're tested with partners allows both people to make informed choices about their sex life.

If the health center at your school doesn't offer testing, take a look at Healthline's guide for information by state, including free, low-cost, and LGBTQ-friendly testing sites in each state.

Abortion

Despite the Supreme Court ruling on Roe v. Wade, abortion remains an essential part of reproductive health care.

Legal issues surrounding access to abortion will continue to play out in state courts as states ban, restrict, or expand access, and those laws are challenged. Students should be aware of the legal restrictions on abortion in the state they go to school in and the state they are a resident of. The New York Times is keeping an updated list of abortion laws by state.

Depending on where you live and go to school, you may be able to access the abortion pill, called mifepristone, which can be prescribed through a telehealth appointment. Although some states are trying to limit access even to abortion pills, the FDA may take measures in the near future to ensure access across the country. This issue will also likely be worked out in the courts over the next few years.

Sexual Education

Sex ed is the cornerstone of reproductive health. Students need to know all of this information to make informed choices about their bodies and their futures. Info on STIs and pregnancy prevention are two of the main components of sex ed. The other is one that often gets left out of the conversation: consent.

A lack of awareness or understanding of how consent works, why it's important, how to ask for it, and how to give it leads to more unwanted sexual encounters, including rape. Sexual assault and rape are already huge issues on college campuses. Data from the National Center for Education Statistics show forcible sex offenses are the most common type of crime on campus. 

It negatively impacts men, women, trans, nonbinary students, same-sex and opposite-sex couples, those in monogamous relationships, people who are married, and anyone who is sexually active. 

One of the most important things you can do is learn about consent and its role in healthy relationships and safe sex. Healthline has a great guide on consent, including how to ask for it, what it sounds and looks like, and consent when alcohol is involved.

Title IX

Introduced in 1972, Title IX is the federal regulation requiring equal access to education regardless of sex. It's often associated with gender equality in higher education and has a long history of securing women's rights in areas like college athletics and requiring schools to adequately handle sexual harassment and assault.

Title IX does not protect access to contraceptives, emergency contraception, or abortion for students. However, it does prohibit discriminating against students on the basis of pregnancy, childbirth, false pregnancy, termination of pregnancy (abortion or miscarriage), or recovery from these conditions.

It also requires universities to excuse absences related to pregnancy, childbirth, miscarriage, abortion, and recovery time as long as your doctor deems it medically necessary.

These protections apply to all aspects of an educational program, including athletics, financial aid, scholarships, career counseling, labs, clinicals, and other areas of the college experience.

The Department of Education released proposed changes at the end of June 2022 that, if passed, would strengthen protections for students based on pregnancy and related conditions.

Title IX and religious exemptions

Schools controlled by religious groups are able to request exemptions to some student protections designated under Title IX. Changes to Title IX under the Trump Administration made it easier for more schools to use religious exemptions and to claim religious exemption after the fact if they are the subject of a Title IX complaint, which is still in effect.

A number of lawsuits from students and alumni of religious colleges are currently challenging the legality of both religious exemptions to Title IX and changes under the Trump Administration.

The Department of Education published a list in 2016 of all colleges that have received waivers to Title IX's pregnancy and parenting provisions since 2009, which Jessica Lee at The Pregnant Scholar has published in an easy-to-read format.

More religious schools may seek waivers to Title IX in the coming years, which could exempt them from legal requirements prohibiting discrimination against certain groups of students.

Confidentiality laws related to student healthcare

Family Education Rights and Privacy Act (FERPA)

FERPA laws protect students' education records. Health records maintained by your university typically are protected by FERPA instead of HIPAA, the law that usually protects health records outside of colleges.

Generally speaking, your school can't disclose your health care records to your parents or others under FERPA without written consent from you. However, there are a few exceptions to this rule. They can disclose information without consent in a health or safety emergency if necessary. Records can also be disclosed if you're under 21 and have violated a law or school policy related to drug and alcohol use or possession, or in compliance with a judicial order or court subpoena.

Essentially, your school can't legally disclose information about your health to your parents without your consent, unless it's a health or safety emergency. However, some parents may have their children sign FERPA waivers or releases. If you signed this form, your parents will be able to access your health records.