Teenage pregnancy, particularly when it involves older men, reveals deep gender and racial inequalities that entrench cycles of disadvantage for young girls. Research has shown that between 20% and 36% of teenage pregnancies result from relationships with men several years older (Boden, Fergusson, & Horwood, 2010; Manlove, Papillo, & Ikramullah, 2004). These pregnancies reflect power imbalances, where young girls—particularly those from ethnic minority backgrounds—are coerced or manipulated into sexual relationships. The overturn of Roe v. Wade and the growing restrictions on abortion access exacerbate this issue, leaving these vulnerable populations, especially ethnic minority girls, at even greater risk. Moreover, the lack of strong policies addressing older men who impregnate preteen girls further highlights the need for comprehensive reform.
Older Men and Teenage Pregnancy: Power and Coercion
The involvement of older men in teenage pregnancies must be understood within the context of gendered and racialized power dynamics. Relationships between older men and young girls are often characterized by significant age gaps and coercive power dynamics. These young girls, especially those from marginalized communities, are particularly vulnerable to such relationships due to factors such as limited emotional and financial support, socioeconomic instability, and cultural pressures that restrict their autonomy.
Research by Manlove et al. (2004) found that approximately 25% of teenage pregnancies stemmed from relationships with men at least five years older than the girl. This issue is more pronounced in ethnic minority communities, where young girls face additional barriers, such as systemic racism, limited access to education, and inadequate healthcare. These power imbalances make it harder for young girls to resist exploitation or make informed decisions about their reproductive health, especially when manipulated by older men.
The Overturn of Roe v. Wade and the Impact on Minority Girls
The Supreme Court’s 2022 decision to overturn Roe v. Wade and return the regulation of abortion to individual states has had profound consequences, especially for young women from marginalized communities. Many states now have restrictive or outright bans on abortion, leaving young girls—particularly those who become pregnant as a result of coercion or relationships with older men—without options. These legal restrictions disproportionately affect ethnic minority girls, who already face substantial barriers to healthcare access.
For these girls, abortion access is further complicated by geographic and financial barriers, as well as parental consent or notification requirements. In states with strict abortion laws, the lack of safe and legal abortion services means that pregnant minors may be forced to carry a pregnancy to term, even if they are ill-prepared emotionally, financially, or socially. This further reinforces cycles of disadvantage, denying these young women the ability to make informed decisions about their futures and exacerbating systemic inequalities (Guttmacher Institute, 2022).
Weak Policies Around Older Men and Preteen Pregnancy
A significant aspect of the problem is the weak policies surrounding older men who impregnate underage girls, particularly preteen girls. Although many states have laws that criminalize sex with minors, these laws are often poorly enforced, and older men who engage in sexual relationships with young girls may face lenient penalties or no consequences at all. This failure to adequately address these situations leaves young girls vulnerable to further exploitation.
For example, many sexual abuse laws fail to adequately consider the unique vulnerabilities of girls in ethnic minority communities, where cultural, social, and economic pressures may prevent them from seeking help or reporting abuse. Even when older men are held accountable, the penalties may be insufficient to deter harmful behaviors or protect young girls from future exploitation (Lammers, Stoker, Jordan, Pollmann, & Fischer, 2011).
Education for Men: Preventing Exploitation Before It Happens
In addressing this issue, it is crucial to focus on preventative measures that can stop exploitation before it occurs. A vital part of this prevention is education. Boys and young men need to be educated early on about the legal and moral consequences of impregnating underage girls. This education should go beyond basic sex education and emphasize the importance of consent, healthy relationships, and the severe consequences of engaging in relationships with minors.
Boys need to understand that exploitation is not only harmful but also punishable by law. By educating young men about these issues, we can foster a culture where sexual exploitation of minors is less likely to occur. Such education can promote respect for boundaries and healthy relationship dynamics, ultimately helping to prevent predatory behavior (Haines & Joffe, 2013).
The Sexualization of Women and Girls in American Culture
The sexualization of women, and especially girls, is embedded in American culture due to the patriarchal structure of society. Media, advertising, and pop culture often portray women and girls as sexual objects, reinforcing the idea that their value is tied to their sexual appeal and appearance. These normalized portrayals of sexual objectification contribute to a societal environment where older men may feel entitled to manipulate or exploit young girls, especially when they view them as available or desirable.
Studies have shown that the sexualization of young girls in the media contributes to the normalization of harmful behaviors toward them. The American Psychological Association (APA, 2007) found that the portrayal of sexualized images of girls in the media negatively impacts their body image, self-esteem, and mental health. Such portrayals create an environment in which young girls are seen as commodities, making it easier for older men to justify their actions of exploitation.
Reproductive Justice and the Need for Stronger Policy
From a feminist perspective, the current state of reproductive rights and protections for young girls is deeply inadequate. Reproductive justice goes beyond the right to abortion and includes the right to live free from violence, coercion, and exploitation. For ethnic minority girls who become pregnant as a result of relationships with older men, this means not only ensuring access to safe and legal abortion services but also strengthening laws to protect these girls from sexual exploitation and abuse.
To achieve reproductive justice, stronger policies are needed to protect young girls from older men who prey on their vulnerability. This includes implementing and enforcing stricter age-of-consent laws, imposing harsher penalties for sexual exploitation, and providing more resources for minors to report abuse and seek help without fear of judgment or retribution. Furthermore, policymakers must ensure that all young women, especially those in marginalized communities, have access to comprehensive sex education, reproductive healthcare, and abortion services (Silliman, Fried, Ross, & Gurr, 2004).
Conclusion
The issue of teenage pregnancy, especially when involving older men, reflects entrenched gender and racial inequalities that limit the autonomy and future opportunities of young girls. The overturn of Roe v. Wade and increasing restrictions on abortion access only exacerbate these challenges, especially for ethnic minority girls who already face significant barriers to healthcare. Additionally, weak policies addressing older men who impregnate preteen girls and the normalization of the sexualization of young girls in American culture contribute to a cycle of exploitation that needs urgent reform.
To move toward true reproductive justice, policies must be reformed to provide stronger protections for young girls, particularly those in marginalized communities. This includes strengthening laws against sexual exploitation, educating young men about the consequences of exploiting minors, ensuring access to reproductive healthcare, and providing comprehensive education and support services for young women. Through these efforts, we can ensure that young girls—regardless of their ethnicity or socioeconomic status—have the opportunity to make informed, autonomous decisions about their bodies and futures.
References
American Psychological Association. (2007). Report of the APA task force on the sexualization of girls. American Psychological Association.
Boden, J. M., Fergusson, D. M., & Horwood, L. J. (2010). Early motherhood and subsequent life outcomes. Journal of Child Psychology and Psychiatry, 51(2), 167-175. https://doi.org/10.1111/j.1469-7610.2009.02191.x
Guttmacher Institute. (2022). Abortion policy in the United States. https://www.guttmacher.org/state-policy
Haines, D., & Joffe, C. (2013). The case for early interventions in preventing sexual violence. American Journal of Public Health, 103(9), 1641-1647. https://doi.org/10.2105/AJPH.2013.301299
Lammers, J., Stoker, J. I., Jordan, J., Pollmann, M., & Fischer, A. H. (2011). Power increases infidelity among men and women. Psychological Science, 22(9), 1191-1197. https://doi.org/10.1177/0956797611416253
Manlove, J., Papillo, A. R., & Ikramullah, E. (2004). The impact of male involvement on adolescent pregnancies and births: A review of the literature. Child Trends. https://www.childtrends.org/publications/the-impact-of-male-involvement-on-adolescent-pregnancies-and-births-a-review-of-the-literature
Silliman, J., Fried, A., Ross, L., & Gurr, L. (2004). Undivided rights: Women of color organize for reproductive justice. South End Press.
OPM Ends Gender-Affirming Care in 2026
By Katherine Walter
On August 25, 2025
In LGBTQ+ rights
To understand the gravity of this reversal, it is necessary to recall how hard-fought the gains for transgender health care under FEHB were. In 2014, OPM lifted the longstanding blanket exclusion of gender-affirming procedures, and by 2016 carriers were instructed not to categorically deny such care. This change aligned federal benefits with emerging medical consensus that gender-affirming treatments are not elective but medically necessary. The World Professional Association for Transgender Health (WPATH) and the Endocrine Society have long affirmed that access to hormone therapy and surgeries significantly reduces psychological distress, improves quality of life, and prevents serious health complications (Hembree et al., 2017; Coleman et al., 2022). For nearly a decade, transgender federal employees and retirees could rely on this coverage as a matter of equity and recognition of their humanity.
As a transgender woman who has been receiving gender-affirming health care for more than eleven years, this policy shift strikes me not just as a bureaucratic adjustment but as a direct threat to my life and well-being. Having undergone an orchiectomy, I rely on estradiol not simply as an affirming treatment, but as essential hormone replacement. Without it, my bones, cardiovascular health, cognition, and emotional stability would be at severe risk. Estradiol for me is no different than thyroid medication for someone with hypothyroidism—it is medically necessary, lifelong care. To see it lumped under a politically charged category of “optional” transition services is both scientifically inaccurate and deeply insulting.
What unsettles me most is the uncertainty this policy creates. OPM’s promise of an “exceptions process” offers little clarity. Will it protect those of us with medical histories spanning over a decade of consistent care? Or will it force us into endless appeals and denials, treating every prescription refill as a battle? This ambiguity is destabilizing, and I cannot help but feel that it is intentional—designed to make care harder to access and to discourage providers from stepping forward.
As a federal retiree, I gave years of service under the assumption that the benefits I earned would protect me equitably. Now, I feel as though my identity has made me a target within the very system I trusted. The estimated 14,000 transgender federal employees and retirees who will be affected are not faceless statistics; we are people who dedicated our careers to serving this country, only to be told that our health care needs are unworthy of recognition (Lambda Legal, 2025; them.us, 2025). The exclusion also signals a dangerous precedent: that essential medical care can be stripped away not because of evidence or cost, but because of politics.
This change must be understood in its broader social context. Over the past decade, transgender Americans have seen both progress and backlash. The Affordable Care Act’s Section 1557 extended nondiscrimination protections in health care, and the Supreme Court’s ruling in Bostock v. Clayton County (2020) affirmed that gender identity is protected under Title VII. Yet, simultaneously, states across the country have passed laws restricting access to gender-affirming care, particularly for youth, framing these measures as cultural wedge issues. The OPM directive extends that wave of exclusion into the federal system, embedding discrimination into the nation’s largest employer-based insurance program.
For me personally, this is not an abstract policy debate. It is about whether I will be able to continue accessing the medication that keeps me healthy and alive. It is about whether the years of progress we celebrated were only temporary reprieves. And it is about what message this sends to younger transgender people entering federal service today: that their health and dignity can be used as bargaining chips in political battles.
I cannot help but feel anxious about what the future holds, but I also feel resolved. This rollback will not go unchallenged. Advocacy groups such as Lambda Legal, the National Center for Transgender Equality, and others have already condemned it as unlawful and are preparing legal strategies (Lambda Legal, 2025). As a transgender woman and a retiree, I plan to add my voice to that chorus, because silence is what allows discrimination to endure. We have fought too hard, and for too long, to let the ground be taken out from under us without resistance.
References
Coleman, E., Radix, A. E., Bouman, W. P., Brown, G. R., de Vries, A. L. C., Deutsch, M. B., … Winter, S. (2022). Standards of Care for the Health of Transgender and Gender Diverse People, Version 8. International Journal of Transgender Health, 23(sup1), S1–S259. https://doi.org/10.1080/26895269.2022.2100644
Hembree, W. C., Cohen-Kettenis, P. T., Gooren, L., Hannema, S. E., Meyer, W. J., Murad, M. H., … T’Sjoen, G. G. (2017). Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons: An Endocrine Society Clinical Practice Guideline. The Journal of Clinical Endocrinology & Metabolism, 102(11), 3869–3903. https://doi.org/10.1210/jc.2017-01658
Lambda Legal. (2025, August 19). Lambda Legal condemns Trump administration’s illegal exclusion of gender-affirming care from employee health benefits. Retrieved August 22, 2025, from https://lambdalegal.org/newsroom
Moss, K. (2025, August 20). Coverage for gender-affirming care will be eliminated from FEHB plans in 2026. Government Executive. Retrieved August 22, 2025, from https://www.govexec.com
Office of Personnel Management. (2025). Carrier Letter 2025-01b: Chemical and surgical sex-trait modification exclusion. Retrieved August 22, 2025, from https://opm.gov
them.us. (2025, August 20). Trump Admin to end coverage of gender-affirming care for federal workers. them. Retrieved August 22, 2025, from https://www.them