A/HRC/32/32 under the Convention on the Rights of the Child, the nature of those protections and their application must reflect the emerging competencies acquired throughout adolescence. 12. The transition towards adulthood is characterized by the changing nature of relationships. Across cultures, adolescents begin to attach far greater significance to and are increasingly influenced by their peer group and less by family and caregivers.14 Adolescents also begin to explore their sexuality, sexual orientation and gender identity. There is considerable diversity in combinations of gender identities, expression and sexual orientation, irrespective of whether such diversity is culturally accepted.15 It is increasingly clear that sexual orientation and gender identity derive from a complex interplay of biological, genetic and social factors and that individuals have little or no choice in its determination.16 13. Supporting adolescents to navigate successfully the challenging path towards healthy emotional, psychosocial, physical and sexual development requires recognition of their rights to information, freedom of expression and association, protection from all forms of violence, safety, bodily integrity and family life, and respect for their dignity and evolving capacities. B. Challenges to the right to health for adolescents 14. Although opportunities for adolescents in many parts of the world have improved in recent years, the second decade of life is associated with exposure to increasing risks to the right to health, including violence, abuse, sexual or economic exploitation, trafficking, harmful traditional practices, migration, radicalization, recruitment into gangs or militias, self-harm, substance use and dependence and obesity. Gender inequalities become more significant as, for example, girls become exposed to child marriage, sexual violence and lower levels of enrolment in secondary education. The world in which adolescents live poses profound challenges, including poverty and inequality, climate change and environmental degradation, urbanization and migration, radical changes in employment potential, aging societies, rising health-care costs and escalating humanitarian and security crises.17 15. States policies towards adolescents are too often characterized by targeted or punitive interventions aimed at addressing problems such as juvenile delinquency and violence, as well as perceived challenges, including substance use and sexual activity; too little attention is typically paid to building positive environments in which adolescents can thrive. Punitive and excessively biomedical interventions ignore the powerful social and economic determinants influencing adolescent behaviour, opportunities and well-being. Stigmatizing, demonizing and discriminating against adolescents by, for example, criminalizing or pathologizing their behaviours and diversities, negatively affects their socially perceived roles, self-esteem, well-being and sense of empowerment. These approaches fail adolescents, their holistic development and their right to health. 16. One-size-fits-all policies designed for children or youth often fail to address adolescents, particularly 10-14 year-olds. Lack of awareness or understanding of their unique health needs can render adolescents invisible. Adolescents face multiple barriers to 14 15 16 17 Clea McNeely and Krishna Bose, “Adolescent social and emotional development : a developmental science perspective on adolescent human rights”, in Human Rights and Adolescence, Jacqueline Bhabha, ed. (2014). Ibid. See www.apa.org/topics/lgbt/orientation.aspx. UNICEF, The State of the World’s Children 2011: Adolescence — An Age of Opportunity (2011). 5