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The no-go zone: a qualitative study of access to sexual and reproductive health services for sexual and gender minority adolescents in Southern Africa.
Reprod Health 2018; 15(1):12RH

Abstract

BACKGROUND

Adolescents have significant sexual and reproductive health needs. However, complex legal frameworks, and social attitudes about adolescent sexuality, including the values of healthcare providers, govern adolescent access to sexual and reproductive health services. These laws and social attitudes are often antipathetic to sexual and gender minorities. Existing literature assumes that adolescents identify as heterosexual, and exclusively engage in (heteronormative) sexual activity with partners of the opposite sex/gender, so little is known about if and how the needs of sexual and gender minority adolescents are met.

METHODS

In this article, we have analysed data from fifty in-depth qualitative interviews with representatives of organisations working with adolescents, sexual and gender minorities, and/or sexual and reproductive health and rights in Malawi, Mozambique, Namibia, Zambia and Zimbabwe.

RESULTS

Sexual and gender minority adolescents in these countries experience double-marginalisation in pursuit of sexual and reproductive health services: as adolescents, they experience barriers to accessing LGBT organisations, who fear being painted as "homosexuality recruiters," whilst they are simultaneously excluded from heteronormative adolescent sexual and reproductive health services. Such barriers to services are equally attributable to the real and perceived criminalisation of consensual sexual behaviours between partners of the same sex/gender, regardless of their age.

DISCUSSION/ CONCLUSION

The combination of laws which criminalise consensual same sex/gender activity and the social stigma towards sexual and gender minorities work to negate legal sexual and reproductive health services that may be provided. This is further compounded by age-related stigma regarding sexual activity amongst adolescents, effectively leaving sexual and gender minority adolescents without access to necessary information about their sexuality and sexual and reproductive health, and sexual and reproductive health services.

Authors+Show Affiliations

Gender, Health and Justice Research Unit, University of Cape Town, Observatory, Cape Town, South Africa. alex.muller@uct.ac.za.Gender, Health and Justice Research Unit, University of Cape Town, Observatory, Cape Town, South Africa.Gender, Health and Justice Research Unit, University of Cape Town, Observatory, Cape Town, South Africa.Gender, Health and Justice Research Unit, University of Cape Town, Observatory, Cape Town, South Africa.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29370809

Citation

Müller, Alex, et al. "The No-go Zone: a Qualitative Study of Access to Sexual and Reproductive Health Services for Sexual and Gender Minority Adolescents in Southern Africa." Reproductive Health, vol. 15, no. 1, 2018, p. 12.
Müller A, Spencer S, Meer T, et al. The no-go zone: a qualitative study of access to sexual and reproductive health services for sexual and gender minority adolescents in Southern Africa. Reprod Health. 2018;15(1):12.
Müller, A., Spencer, S., Meer, T., & Daskilewicz, K. (2018). The no-go zone: a qualitative study of access to sexual and reproductive health services for sexual and gender minority adolescents in Southern Africa. Reproductive Health, 15(1), p. 12. doi:10.1186/s12978-018-0462-2.
Müller A, et al. The No-go Zone: a Qualitative Study of Access to Sexual and Reproductive Health Services for Sexual and Gender Minority Adolescents in Southern Africa. Reprod Health. 2018 Jan 25;15(1):12. PubMed PMID: 29370809.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The no-go zone: a qualitative study of access to sexual and reproductive health services for sexual and gender minority adolescents in Southern Africa. AU - Müller,Alex, AU - Spencer,Sarah, AU - Meer,Talia, AU - Daskilewicz,Kristen, Y1 - 2018/01/25/ PY - 2017/11/20/received PY - 2018/01/22/accepted PY - 2018/1/27/entrez PY - 2018/1/27/pubmed PY - 2018/9/1/medline KW - Adolescents KW - Criminalisation KW - HIV KW - Heteronormativity KW - LGBT KW - Service provision KW - Sexual and gender minorities KW - Sexual and reproductive health and rights KW - Southern Africa KW - Stigma SP - 12 EP - 12 JF - Reproductive health JO - Reprod Health VL - 15 IS - 1 N2 - BACKGROUND: Adolescents have significant sexual and reproductive health needs. However, complex legal frameworks, and social attitudes about adolescent sexuality, including the values of healthcare providers, govern adolescent access to sexual and reproductive health services. These laws and social attitudes are often antipathetic to sexual and gender minorities. Existing literature assumes that adolescents identify as heterosexual, and exclusively engage in (heteronormative) sexual activity with partners of the opposite sex/gender, so little is known about if and how the needs of sexual and gender minority adolescents are met. METHODS: In this article, we have analysed data from fifty in-depth qualitative interviews with representatives of organisations working with adolescents, sexual and gender minorities, and/or sexual and reproductive health and rights in Malawi, Mozambique, Namibia, Zambia and Zimbabwe. RESULTS: Sexual and gender minority adolescents in these countries experience double-marginalisation in pursuit of sexual and reproductive health services: as adolescents, they experience barriers to accessing LGBT organisations, who fear being painted as "homosexuality recruiters," whilst they are simultaneously excluded from heteronormative adolescent sexual and reproductive health services. Such barriers to services are equally attributable to the real and perceived criminalisation of consensual sexual behaviours between partners of the same sex/gender, regardless of their age. DISCUSSION/ CONCLUSION: The combination of laws which criminalise consensual same sex/gender activity and the social stigma towards sexual and gender minorities work to negate legal sexual and reproductive health services that may be provided. This is further compounded by age-related stigma regarding sexual activity amongst adolescents, effectively leaving sexual and gender minority adolescents without access to necessary information about their sexuality and sexual and reproductive health, and sexual and reproductive health services. SN - 1742-4755 UR - https://www.unboundmedicine.com/medline/citation/29370809/The_no_go_zone:_a_qualitative_study_of_access_to_sexual_and_reproductive_health_services_for_sexual_and_gender_minority_adolescents_in_Southern_Africa_ L2 - https://reproductive-health-journal.biomedcentral.com/articles/10.1186/s12978-018-0462-2 DB - PRIME DP - Unbound Medicine ER -