Dear Editor, In this contemporary era of the 21st century–where equity, equality, and empowerment are widely promoted–it is disheartening that adolescents still have to deal with deeply rooted gender-based disparities. Adolescence represents a vital stage in identity formation; however, many adolescents–particularly girls and gender-diverse youths–encounter social, cultural, and institutional obstacles that impede their health, autonomy, and overall well-being. This letter aims to draw attention to these critical issues and urge educators, healthcare providers, and policymakers to adopt inclusive, rights-based strategies that safeguard adolescent well-being and promote gender equity. Across the globe, especially in India and South Asia, adolescent girls are disproportionately affected by early marriage, dropping out of school, and limited access to reproductive health services. At the same time, boys face social pressures related to masculinity that discourage emotional expression and seeking help. Gender-diverse adolescents, including those identifying themselves as Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, and Asexual and others (LGBTQIA+), face exclusion, bullying, and serious mental health challenges because of systemic stigma and a lack of support in schools, health care, and even within families.1,2 One of the most alarming consequences of these disparities is the consistently high rate of adolescent pregnancies. The National Family Health Survey-5 (2019–2021) reports that 6.8% of women aged 15–19 in India have already begun childbearing, with rates rising to 16% in West Bengal and 11% in Bihar.3 Early marriage continues to be a major factor, with 23.3% of women aged 20–24 married before 18, particularly in rural and marginalized communities.3 In addition, unreported sexual abuse by known individuals or strangers remains a concealed cause of pregnancy among many adolescents, compounded by stigma, fear, and lack of protective measures.4,5 Despite the scale of these issues, significant programmatic and policy gaps persist. Although various programs and policies exist, their implementation is weak and fragmented. Comprehensive Sexuality Education (CSE) remains inconsistently implemented; Gender-based Violence (GBV) among adolescents is poorly tracked; and adolescents identifying themselves as LGBTQIA+ are largely excluded from health and education systems. Cyber harassment is on the rise, yet educational institutions and healthcare institutions often lack preventive or reporting mechanisms. Out-of-school adolescents, those with disabilities, and those in tribal areas remain underserved. Moreover, adolescents are rarely consulted in shaping the very programs meant for them. As discussed in our earlier correspondence on integrating gender-based violence in healthcare systems,6 the lack of inclusive, intersectional strategies remains a persistent gap.7 Addressing adolescent gender issues demands that we move beyond generic programs to targeted and rights-based action. These strategies should be both inclusive, ensuring the participation and protection of marginalized groups such as LGBTQIA youth, rural girls, and adolescents with disabilities, and also rights-based, grounded in principles of bodily autonomy, informed consent, gender equity, and access to essential services. Specifically, the following strategies are proposed:4-7 Implement rights-based CSE in all academic institutions, covering consent, gender diversity, and digital safety Train teachers, Accredited Social Health Activists (ASHAs), and frontline staff on adolescent mental health, GBV risk screening, and inclusive communication; Strengthen Rastriya Kishor Swasthya Karyakram (RKSK) clinics and outreach to reach marginalized, out-of-school, and LGBTQIA+ youth; Ensure cyber safety protocols in academic institutions and health care facilities, with adolescent-friendly reporting systems; Institutionalize adolescent participation through district-level youth advisory groups; And most critically, integrate child protection, health, and legal aid systems for seamless care of adolescents facing early marriage, abuse, or violence. Adolescents are not just future citizens–they are active contributors today. Ensuring their gender rights, bodily autonomy, and well-being is not just a health issue; it is a societal imperative for any nation aspiring to be just and inclusive. To achieve this, it is essential to ensure multisectoral coordination, bringing together health, education, child protection, legal systems, and community stakeholders, to translate policies into meaningful and accessible support for every adolescent. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.
Kulkarni et al. (Sat,) studied this question.