{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T03:42:09Z","timestamp":1776224529137,"version":"3.50.1"},"reference-count":37,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,6,4]],"date-time":"2024-06-04T00:00:00Z","timestamp":1717459200000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000862","name":"Doris Duke Charitable Foundation","doi-asserted-by":"publisher","award":["#2020143"],"award-info":[{"award-number":["#2020143"]}],"id":[{"id":"10.13039\/100000862","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Perspect Sexual Reproductive"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In the United States (U.S.), adolescents and young adults are increasingly using contraception, including long\u2010acting reversible contraception (LARC) [e.g., subdermal implants (e.g., Nexplanon\u00ae) and intrauterine devices (IUDs)]; however, access to LARC device removal may be difficult for adolescents and young adults. Reproductive justice is the right to bodily autonomy, have children, not have children, and safely parent the children we have.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this commentary, we discuss that while the specialties of family medicine and obstetrics and gynecology have incorporated the principles of reproductive justice into their contraceptive care, further work is needed to ingrain this philosophy into pediatrics training. Since LARC devices are historically only removable by health care providers, pediatricians may act as gatekeepers to removing LARC, obstructing the reproductive justice of adolescents and young adults.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We describe that adolescents and young adults in the U.S. face unique barriers to LARC removal including limited access to the health care system, potential breaches in confidentiality, and provider bias. These barriers may lead adolescents and young adults to remove their own LARC device when experiencing unwanted side effects or desiring pregnancy. While IUD self\u2010removal is a safe and accessible option, safety and efficacy data on subdermal implant self\u2010removal is currently limited.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In order to promote reproductive justice in adolescents and young adults, we recommend that (1) pediatricians should address potential barriers to LARC removal prior to insertion, (2) pediatricians must offer unbiased LARC removal, (3) pediatricians who place LARC must be knowledgeable about complicated LARC removal, and (4) pediatricians should discuss LARC self\u2010removal options with adolescents and young adults.<\/jats:p><\/jats:sec>","DOI":"10.1111\/psrh.12270","type":"journal-article","created":{"date-parts":[[2024,6,5]],"date-time":"2024-06-05T06:54:26Z","timestamp":1717570466000},"page":"85-89","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Increasing access to <scp>LARC<\/scp> removal in pediatrics to support adolescent reproductive justice in the United States"],"prefix":"10.1111","volume":"56","author":[{"given":"Joline S.","family":"Hartheimer","sequence":"first","affiliation":[{"name":"The University of North Carolina School of Medicine  Chapel Hill North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bianca A.","family":"Allison","sequence":"additional","affiliation":[{"name":"Division of General Pediatrics and Adolescent Medicine The University of North Carolina School of Medicine  Chapel Hill North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martha F.","family":"Perry","sequence":"additional","affiliation":[{"name":"Division of General Pediatrics and Adolescent Medicine The University of North Carolina School of Medicine  Chapel Hill North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,6,4]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.conx.2021.100064"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2014\u20102299"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020\u2010007252"},{"key":"e_1_2_10_5_1","volume-title":"Reproductive Justice","author":"Sister Song","year":"2022"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000004659"},{"key":"e_1_2_10_7_1","volume-title":"RHEDI: Reproductive Health Education In Family Medicine","year":"2023"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2016.04.012"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.conx.2021.100063"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2016.303393"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001213"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2018.304556"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOP.0000000000001008"},{"key":"e_1_2_10_14_1","unstructured":"American College of Obstetricians and Gynecologists' Committee on Adolescent Health Care. 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