Sexual and Reproductive Health Web Sites: An Analysis of Content for Sexual and Gender Minority Youth

Abstract

Purpose: Sexual and gender minority (SGM) youth face risks for negative sexual and reproductive health (SRH) outcomes; it is critical to provide these populations with health education that is both inclusive of and specific to their needs. We sought to characterize the strengths and weaknesses of SGM-related messages from web sites that address SRH for young people. We considered who is included, what topics are discussed, and how messages are framed. Methods: A systematic Google search and screening process was used to identify health promotion web sites with SRH content for adolescents and young adults. Using MAXQDA, we thematically coded and analyzed SGM content qualitatively. Results: Of 32 SRH web sites identified, 23 (71.9%) contained SGM content. Collectively, the sites included 318 unique SGM codes flagging this content. Approximately two-thirds of codes included messages that discussed SGM youth in aggregate (eg, lesbian, gay, bisexual, and transgender)—specific content about the diverse subpopulations within this umbrella term (eg, transgender youth) was more limited. In addition to SRH topics, most web sites had messages that addressed a broad array of other health issues including violence, mental health, and substance use (n = 17, 73.9%) and SGM-specific topics, for example coming out (n = 21, 91.3%). The former were often risk-framed, yet affirmational messages were common. Most web sites (n = 16; 69.6%) presented information for SGM youth both in stand-alone sections and integrated into broader content. Yet, integrated information was slightly more common (56.6% of all codes) than stand-alone content. Conclusions: Challenges of developing SRH content related to SGM youth include: (1) aggregate terms, which may not represent the nuances of sexual orientation and gender, (2) balancing risk versus affirmational messages, and (3) balancing stand-alone versus integrated content. However, SGM-related content also offers an opportunity to address diverse topics that can help meet the needs of these populations.

Structural Racism and Its Influence On Sexual and Reproductive Health Inequities Among Immigrant Youth

“…Indeed, historically when we think about the term inclusivity in the context of sexuality education, it generally references materials and approaches focused on LGBTQ + identified folk. [ 16 , 25 ] While important, this framework may leave out other historically marginalized communities, including racial and ethnic minoritized populations, persons with disabilities, and immigrant populations. [ 23 , 26 ] Even still, inclusive sexuality education for LGBTQ + youth is sub-optimal and often does not reflect the intersectional identities of youth.…”

“…[ 23 , 26 ] Even still, inclusive sexuality education for LGBTQ + youth is sub-optimal and often does not reflect the intersectional identities of youth. [ 25 ] Most U.S.-based sexuality education has been designed by and for cis-gender, mainland U.S.-born white people without disability, and has historically failed to reach and impact historically marginalized students and communities. It is important for historically marginalized populations, such as immigrant youth, to see their intersectional identities reflected in their materials and modes of learning, which serves as an important incentive to address the ways that current U.S-based sexuality education fails to influence immigrant youth.…”

Examining LGBTI+ inclusive sexual health education from the perspective of both youth and facilitators: a systematic review

“… 22 Four examined professional experiences of delivering sexual health education. 14 15 22 23 One examined the impact of abstinence only sexual health education, 16 one examined the content of reproductive and sexual health web sites for sexual and gender minority youth 37 and one examined sexual health online interventions in a men who have sex with men (MSM) chatroom. 33 Three main categories were derived from the content analysis: (1) online learning, (2) inclusive programme components and (3) facilitator attributes.…”

“We have to figure it out ourselves”: Transfeminine adolescents’ online sexual experiences and recommendations for supporting their sexual health and wellbeing

“…Healthcare providers may rely on TGD individuals to provide education about gender-related health issues, which exacerbates existing health care inequity for TGD youth relative to their cisgender peers. The American Psychological Association's practice guidelines for TGD individuals ( 3 ) encourage psychologists to discuss contraception and safe sex practices; however, there is limited information about whether existing sexual and reproductive health (SRH) resources, education or clinic-based counseling meets the needs of TGD youth ( 4 , 5 ). Limited data on the early sexual experiences of TGD youth suggest higher risk of poor SRH outcomes (e.g., sexually transmitted infections, sexual assault) ( 6 ) and less sexual or romantic experience than cisgender peers ( 7 ).…”

“…Limited data on the early sexual experiences of TGD youth suggest higher risk of poor SRH outcomes (e.g., sexually transmitted infections, sexual assault) ( 6 ) and less sexual or romantic experience than cisgender peers ( 7 ). TGD youth may experience difficulty finding relevant, trustworthy SRH content for gender diverse individuals ( 4 , 5 ) and due to prior stigmatizing experiences with healthcare providers, may avoid asking sexual health questions ( 5 ). Healthcare providers working with adolescents, though familiar with SRH resources and counseling, may lack training in sexual and gender minority health and familiarity with the specific needs of TGD youth.…”