02 Jun Providing Sexual Health Service for LGBTQ Youth



Examining Clinicians’ Experiences Providing Sexual Health Services for LGBTQ Youth: Considering Social and Structural Determinants of Health in Clinical Practice


Why this Research is Important

There is research to support that youth identifying as LGBTQ (lesbian, gay, bisexual, transgender and queer) experience barriers to accessing sexual health services. However, there is a lack of research investigating the perceptions and experiences of clinicians working with these youth. A qualitative study by Knight, Shoveller, Carson and Contreras-Whitney (2014) addresses this gap in the research.


Knight and colleagues conducted semi-structured, in-depth interviews with 19 nurses and five physicians who provide sexual health services to youth under the age of 25 in British Columbia.




1    Experiences of clinicians offering sexual health services to LGBTQ youth inside of the heterosexual status quo.

Many respondents conveyed they felt frustrated that they were inadequately prepared with skills to counsel LGBTQ youth effectively and competently. Furthermore, a lack of organizational support (e.g., training, resources) to offer sexual and reproductive health services that addresses the needs of these youth was identified as the dominant barrier.


2    Reflections regarding clinical practice and the social determinants of LGBTQ youths’ sexual health. 

Respondents discussed how their own heterosexual identity can influence their interactions with clients such as not giving youth sufficient opportunity to discuss their sexuality.
They also underscored the importance of tackling heteronormative assumptions regarding a person’s sexual orientation or gender identity. Respondents identified the challenges of addressing behaviour change on an individual level (e.g., safer sex counselling) and identified that alignment with LGBTQ non-clinical services is needed to support youth.


3    Shifting practices or replicating the status quo. 

Some respondents explained times they challenged their organization’s rules or norms related to the sexual health of LGBTQ youth. Others spoke to the importance of modifying typical clinical practices to address the needs of LGBTQ youth. Others discussed times where the protocol they followed did not address the needs of LGBTQ youth (e.g., asking transgender youth about their biological sex and anatomy).




This study supports the importance of not making assumptions about a person’s sexual orientation or gender identity. Many respondents felt they lacked institutional supports or the skills to adequately and competently address the sexual and reproductive health needs of LGBTQ youth. Therefore this study supports (a) the need for clinician training and support; and (b) examination of institutional barriers that support heteronormative practices.




Knight, R. E., Shoveller, J. A., Carson, A. M., & Contreras-Whitney, J. G. (2014). Examining clinicians’ experiences providing sexual health services for LGBTQ youth: Considering social and structural determinants of health in clinical practice. Health Education Research, 29(4), 662-670.