Thank you so much for your insightful, and distressing, answers. Your experience with missionary providers illuminates so many of these issues, both on the structural and the interpersonal side. The hubris and/or lack of awareness that these providers must have had to work this way underlines so much of the problematic hierarchy and lack of self-reflection that is common in medicine, and which has a large impact on health care disparities.
Your research in sexual and reproductive health is a good example of how certain areas of health care can be so stigmatized and/or under-resourced that, while all patients are impacted, those with the least resources/empowerment have the most negative impacts. It is similar to the US before Roe v. Wade, when women with money and/or connections could access safe abortion services, but those without these resources either continued pregnancies or were subject to risky procedures that often resulted in death or disability - thereby exacerbating social and medical disparities. I like your attention to youth friendly services as an approach to dealing with the problem of access to sexual and reproductive services.