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Overcoming barriers to sexual healthcare for bisexual adolescent girls

Concerns regarding providers’ disclosure of confidential information when speaking to parents and bisexual stigma within families are other important factors that can keep adolescent girls from openly discussing their sexuality in the healthcare setting, according to a new study published in LGBT Health.

Bisexual teenage girls are likely to miss out on the sexual healthcare information and services they need if healthcare providers present judgmental attitudes and assume patients’ heterosexuality. Concerns regarding providers’ disclosure of confidential information when speaking to parents and bisexual stigma within families are other important factors that can keep adolescent girls from openly discussing their sexuality in the healthcare setting, according to a new study published in LGBT Health, a peer-reviewed journal from Mary Ann Liebert, Inc., publishers.

In “Bisexual Invisibility and the Sexual Health Needs of Adolescent Girls,” Miriam Arbeit, PhD andCelia Fisher, PhD, Fordham University (New York, NY) and Kathryn Macapagal, PhD and Brian Mustanski, PhD, Northwestern University (Chicago, IL) examined how bisexual girls’ perceptions of healthcare providers’ attitudes and behaviors, social stigmas within families, and sexual health education provided in schools could affect their access to sexual health services and information.

In the study, bisexual female participants indicated three aspects of provider behaviors that most affected their healthcare experiences: (1) negative bias regarding adolescent sexual behavior in general and same-sex attraction in particular, (2) providers assuming they were heterosexual, and (3) providers missing relevant opportunities to screen for HIV and other STIs.

The researchers concluded that the girls wanted their providers to be open and nonjudgmental and that they were willing to speak with providers about their sexual orientation but were unlikely to initiate the conversation. The authors emphasize the importance of primary care providers asking adolescent girls about sexual attraction, behavior, and identity, and taking advantage of opportunities to talk about sexual healthcare, educate patients, and test for HIV and sexually transmitted infections.

The study’s authors recommended: “Delivering sexual healthcare in a nonjudgmental manner and integrating questions and information about bisexual attraction into standard contraceptive care, condom counseling, and HPV vaccination can increase opportunities for bisexual girls to learn about ways they can best protect their health. Furthermore, there were participants in this study who were either unaware of STI risks involved in sex between women, or who did not know of any available protection methods. It is beyond the scope of this article to assess clinical indication for and acceptability of barrier methods such as gloves and dental dams for sex between women. However, sharing the extent of the risks and options for risk reduction is an important part of supporting girls’ personal sexual health decision making. These provider practices can strengthen bisexual girls’ engagement in healthcare, and should be implemented alongside HIV/STI testing for sexually active youth.”

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