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Williams N, Griffin G, Wall M, Bradfield Z. The sexual and reproductive health knowledge of women in Australia: A scoping review. Health Promot J Austr 2024. [PMID: 39097983 DOI: 10.1002/hpja.908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 05/28/2024] [Accepted: 07/18/2024] [Indexed: 08/06/2024] Open
Abstract
ISSUE ADDRESSED Sexual and reproductive health (SRH) knowledge influences health literacy and promotes positive health behaviours. This scoping review explores the SRH knowledge of women in Australia and reports on knowledge assessment, ways of learning, enablers and barriers, and interventions to improve knowledge. METHODS Seven databases were searched for eligible articles published in English between 2012 and 2022. RESULTS Eighty-five sources were included for analysis. Data were mapped by knowledge topic and population group and charted against four review objectives. Assessment of knowledge was the primary focus in 59% of sources. Two sources used a validated knowledge assessment tool. Knowledge was assessed using self-assessment, a measurement of correctness, or both. Women learnt about SRH through a range of sources, including healthcare providers, peers, family, internet, and school. Enablers and barriers spanned information content, delivery, timing, accessibility, interactions with those providing information, cultural and gendered norms, pre-migration experiences, and functional health literacy. Nine sources reported on interventions to facilitate SRH knowledge. CONCLUSIONS This review identified topics, population groups, and gaps in assessment of SRH knowledge of women in Australia. Overall, the measurement of women's SRH knowledge is largely conducted using unvalidated tools focusing on specific topics. SO WHAT?: It is recommended a validated tool be developed to comprehensively assess the SRH knowledge of women in Australia allowing for intersectional population analysis and exploration of knowledge conceptualisation. This would enable assessment of interventions aiming to improve SRH knowledge thereby facilitating improved health literacy and outcomes.
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Affiliation(s)
- Natalie Williams
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Western Australia, Australia
- School of Nursing, Curtin University, Bentley, Western Australia, Australia
| | - Georgia Griffin
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Western Australia, Australia
| | - Megan Wall
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Western Australia, Australia
| | - Zoe Bradfield
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Western Australia, Australia
- School of Nursing, Curtin University, Bentley, Western Australia, Australia
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Lim G, Bourne A, Hill A, McNair R, Lyons A, Amos N. Community connection is associated with lower psychological distress for sexual minority women who view community connection positively. CULTURE, HEALTH & SEXUALITY 2024; 26:513-530. [PMID: 37452686 DOI: 10.1080/13691058.2023.2231043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 06/26/2023] [Indexed: 07/18/2023]
Abstract
We examined factors associated with sexual minority women's evaluations of belonging to the lesbian, gay, bisexual, transgender and queer (LGBTQ) community in Australia, and assessed whether a positive view of community participation impacted levels of psychological distress. 2424 cisgender sexual minority women participated in a national, online, cross-sectional survey of LGBTIQ adult Australians' health and well-being. Multivariable regression analyses were conducted to investigate sociodemographic factors associated with sexual minority women's belonging to the LGBTQ community, feelings towards community connection, and associations between community connection and recent psychological distress. Most sexual minority women (58.9%) reported feeling that they are part of the LGBTQ community, and a majority of the participants felt positive about being connected to this community (68.5%). Participants who were bisexual, non-university educated, and who resided in an outer-suburban location were least likely to evaluate participation in the LGBTQ community positively. Feeling positive about community connection was associated with lower levels of psychological distress. Feeling a part of LGBTQ community was associated with lower psychological distress, but this link appears contingent upon positive feelings about community participation. Sexual minority women's' relationships to the LGBTQ community are often complex, and community connection and participation in and of itself is not a panacea for the negative outcomes associated with sexual minority stressors.
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Affiliation(s)
- Gene Lim
- Australian Research Centre for Sex, Health and Society, La Trobe University, Melbourne, VIC, Australia
| | - Adam Bourne
- Australian Research Centre for Sex, Health and Society, La Trobe University, Melbourne, VIC, Australia
| | - Adam Hill
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
| | - Ruth McNair
- Department of General Practice, University of Melbourne, Melbourne, VIC, Australia
| | - Anthony Lyons
- Australian Research Centre for Sex, Health and Society, La Trobe University, Melbourne, VIC, Australia
| | - Natalie Amos
- Australian Research Centre for Sex, Health and Society, La Trobe University, Melbourne, VIC, Australia
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Henningham M. Nowhere to bi: Barriers to belonging in the broader LGBTQ+ community for Aboriginal bi+ people in Australia. JOURNAL OF LESBIAN STUDIES 2023; 28:63-83. [PMID: 37652438 DOI: 10.1080/10894160.2023.2233339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Having a multiplicity of identities not only makes it difficult to find inclusive spaces for Aboriginal bisexual+ (bi) people but may often be a barrier to building connections and relationships with people who have other queer identities. Bi + identities alone are often rendered invisible, unintelligible or erased when it comes to inclusion and solidarity among their peers. An intersectional lens is used to reflexively investigate existing literature to explore how a lack of solidarity among lateral communities may impact Aboriginal bi + people in Australia who face an array of racism and queerphobia from both LGBTQ + and Aboriginal communities. These unique and multifaceted layers of discrimination greatly impact mental health and wellbeing. These experiences stem from the heterosexist and monosexist status quo from heteropatriarchal settler colonialism that is seen in both Aboriginal and LGBTQ + communities respectively. As a result, Aboriginal queer people are constantly surveying risks, policing their own identities and identity expression, often hiding parts of their identity as a survival strategy to avoid rejection and adhere to dominant cultural norms. When specifically considering Aboriginal bi + identities, there are added unique stressors of lateral violence with other LGBTQ + groups, antibisexual prejudice, and assumed monosexuality, adding additional layers of minority stress. The author explores these experiences by extending upon borderland theory and minority stress models. Whilst there is solace in the holistic celebration of intersecting identities in emerging intersectional Aboriginal queer spaces, there is still a great need for solidarity and celebration of Aboriginal bi + people within the broader LGBTQ + community.
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Affiliation(s)
- Mandy Henningham
- Department of Sociology and Social Policy, Faculty of Arts and Social Sciences, The University of Sydney, Camperdown, NSW, Australia
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Telling Disabled and Autistic Sexuality Stories: Reflecting upon the Current Research Landscape and Possible Future Developments. SEXES 2023. [DOI: 10.3390/sexes4010010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
Abstract
Developments in the study of sexuality in the lives of disabled people have been relatively slow, as the spectre of a medicalised model continues to dominate most debates and invalidate any form of sexual identity. The social model of disability has enabled the amplification of voices that have been previously silenced; however, progress has stalled. Within autism studies, however, the rise of neurodiversity studies coupled with intersectionality, has presented an opportunity to explore sexualities in terms of difference rather than deficiency, therefore bypassing deficit models which have dominated any study of non-heterosexual lives. Such deficit models have focussed upon discovering what it is about autism that leads autistic people to think they are non-heterosexual, often resulting in a lack of support for young LGBT+ people as sexuality is dismissed as a result of autism. Reflecting upon findings from my own ongoing work alongside emerging social research, this article explores important developments and potential future directions. This will highlight the progress made and the barriers remaining. Using a sociological approach and a framework inspired by Plummer, which focusses upon the importance of sexual stories, the article will show that much needs to be done. The diversity of goals and multiplicity of stories means that disabled and autistic sexuality stories have not been accepted into the public consciousness.
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Epps B, Markowski M, Cleaver K. A Rapid Review and Narrative Synthesis of the Consequences of Non-Inclusive Sex Education in UK Schools on Lesbian, Gay, Bisexual, Transgender and Questioning Young People. J Sch Nurs 2023; 39:87-97. [PMID: 34605714 PMCID: PMC9841814 DOI: 10.1177/10598405211043394] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Relationships and Sex Education (RSE) in schools are predominantly heterocentric. Consequently, lesbian, gay, bisexual, transgender, and questioning young people have reported feeling excluded. This exclusion results in feelings of being "different" and "other," which in turn leads to further disengagement in the sex education classroom, contributing to poor sexual health literacy, greater risk of abusive relationships, and higher rates of sexually transmitted infections. A rapid review was undertaken to identify the impact of non-inclusive sex education. The review makes recommendations for policy and practice, which includes the provision of training courses to school teaching staff with an emphasis on inclusive RSE, appropriate online resources for lesbian, gay, bisexual transgender, and questioning (LGBTQ) young people, as well as offering 1:1 emotional health support for LGBTQ young people as they begin to question their sexual orientation.
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Affiliation(s)
- Beth Epps
- Kent School Health Team, Children and Young People's Directorate, Kent Community Health NHS Foundation Trust, Maidstone, UK
| | - Marianne Markowski
- Institute for Lifecourse Development, Faculty of Education, Health and Human Sciences, University of Greenwich, London, UK,Marianne Markowski, Research Fellow, Institute for Lifecourse Development, Faculty of Education, Health and Human Sciences, University of Greenwich, London, UK.
| | - Karen Cleaver
- Faculty of Education, Health and Human Sciences, University of Greenwich, London, UK
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Hindes S. How COVID-19 is (and is not) changing the way we talk about sex and dating: A critical analysis of sex advice during the pandemic. SEXUALITIES 2022:13634607221112648. [PMCID: PMC9253721 DOI: 10.1177/13634607221112648] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
In this article, we applied a ‘sex critical’ lens to discursively analyse online sex advice available to Australian readers in the first 3 months of ‘lockdown’ during the COVID-19 pandemic (March–June 2020). We explored how sex and intimacy were being talked about within the pandemic context, examining if and how this was different to pre-pandemic sex advice. We found both the perpetuation of dominant discourses that limit understandings of sex and sexual practices, and challenges to these which open exciting possibilities for new sexual intimacies.
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Affiliation(s)
- Sophie Hindes
- Sophie Hindes, School of Social and Political Sciences, Level 4, John Medley Building, The University of Melbourne Parkville, VIC 3010 Australia.
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Postpartum Help-Seeking: The Role of Stigma and Mental Health Literacy. Matern Child Health J 2022; 26:1030-1037. [PMID: 35258854 DOI: 10.1007/s10995-022-03399-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2021] [Indexed: 10/18/2022]
Abstract
BACKGROUND Postpartum depression is the most common complication associated with child-bearing. The current study investigated attitudes toward professional psychological help-seeking and the effects of stigma and mental health literacy on postpartum women recruited from social media (N = 326). METHOD Hierarchical linear regression was used to analyze the data and the interaction effect of stigma and mental health literacy. RESULTS Stigma was negatively associated with attitudes toward professional psychological help-seeking, while mental health literacy was positively associated with attitudes toward professional psychological help-seeking. The interaction effect was not statistically significant. The results yield implications for screening practices and reducing stigma for mental health care in the postpartum period.
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Whitlock MC. 'I never realised that sex between two women was not safe': narratives of lesbian safer sex. CULTURE, HEALTH & SEXUALITY 2022; 24:288-299. [PMID: 33512310 DOI: 10.1080/13691058.2020.1855367] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 11/20/2020] [Indexed: 06/12/2023]
Abstract
This paper explores the way in which some lesbians rely on culturally circulated narratives about identity to assess safer sex and their potential risk of sexually transmitted infection (STI) and HIV. A well-established narrative within the literature about lesbian safer sex is that STI risk is non-existent. The implications of this are important because they demonstrate the perception of lesbian identity and notions of safety. This study focuses on how gender and sexuality contextualise an assessment of risk and safety for lesbians. This is vital to understand because there is still a lack of language about lesbian safer sex practices and techniques. Lesbians narrate their assessments of STI and HIV risk through the lenses of gender and sexuality - locating 'risk' in gay men and bisexual women. Using narrative analysis, I find that lesbians assess their risk by constructing characters from culturally circulated narratives steeped in homophobia and biphobia of the sensible lesbian, the risky gay man and the uncertain bisexual.
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Affiliation(s)
- M C Whitlock
- Department of Sociology, Georgia Southwestern State University, Americus, GA, USA
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MacAulay M, Ybarra M, Saewyc E, Sullivan R, Jackson L, Millar S. 'They Talked Completely about Straight Couples Only': Schooling, Sexual Violence and Sexual and Gender Minority Youth. SEX EDUCATION 2022; 22:275-288. [PMID: 35600717 PMCID: PMC9122334 DOI: 10.1080/14681811.2021.1924142] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 04/27/2021] [Indexed: 05/19/2023]
Abstract
Scholarly conversations regarding sexual violence and sexuality education typically emphasise cisgender and heterosexual experiences, leaving sexual and gender minority young people's voices unheard. This happens despite adolescence being a crucial period for the onset of sexual violence, with sexual and gender minority youth reporting elevated levels of victimisation. Moreover, the preponderance of research focusing on victimisation suggests notable gaps in our understanding of sexual violence perpetration. This study examined contextual factors shaping sexual violence victimisation and perpetration among sexual and gender minority youth, with school playing a key role. Based on qualitative data from semi-structured interviews with 50 young people aged 14-26 years who self-reported sexual violence perpetration in the Growing Up with Media survey, the analysis demonstrates how schooling's 'hidden curriculum' leaves sexual and gender minority youth ill-equipped to navigate the world of sexuality. Formal sexuality education remains heteronormative and gender-segregated, resulting in incomplete understandings of sexual violence. At the informal level, gendered double standards and peer norms reinforce the second-class sexual citizenship of sexual and gender minority youth. Our findings suggest that schools may be complicit in sexual violence victimisation and perpetration by sending limited and mixed messages regarding gender and sexuality. Research and policy implications are discussed.
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Affiliation(s)
- Margaret MacAulay
- Stigma and Resilience Among Vulnerable Youth Centre (SARAVYC), School of Nursing, University of British Columbia, Canada
- Corresponding author: Margaret MacAulay.
| | - Michele Ybarra
- Center for Innovative Public Health Research, San Clemente, CA, USA
| | - Elizabeth Saewyc
- Stigma and Resilience Among Vulnerable Youth Centre (SARAVYC), School of Nursing, University of British Columbia, Canada
| | - Richard Sullivan
- Stigma and Resilience Among Vulnerable Youth Centre (SARAVYC), School of Nursing, University of British Columbia, Canada
| | - Lauren Jackson
- Center for Innovative Public Health Research, San Clemente, CA, USA
| | - Shannon Millar
- Stigma and Resilience Among Vulnerable Youth Centre (SARAVYC), School of Nursing, University of British Columbia, Canada
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Grant R, Nash M, Hansen E. What does inclusive sexual and reproductive healthcare look like for bisexual, pansexual and queer women? Findings from an exploratory study from Tasmania, Australia. CULTURE, HEALTH & SEXUALITY 2020; 22:247-260. [PMID: 30958103 DOI: 10.1080/13691058.2019.1584334] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 02/13/2019] [Indexed: 06/09/2023]
Abstract
Increased awareness of the health disparities faced by lesbian, gay, bisexual, transgender, intersex and queer (LGBTIQ) people has driven the need for LGBTIQ-inclusive medical practices internationally. However, despite bisexual, pansexual and queer women's increased sexual health risks and reduced engagement with health services, there is little qualitative research examining their healthcare experiences. In addition, healthcare practitioners continue to report lack of awareness and competence in inclusive practice, particularly regarding these groups. To address these gaps in the literature and practice, this study draws on 21 qualitative interviews with women and general practitioners, comparing and contrasting their understandings and experiences of inclusive sexual and reproductive healthcare. Findings reveal that women value practitioners who take a non-judgemental approach, use inclusive language and are knowledgeable or willing to self-educate about LGBTIQ issues. Practitioners describe prioritising visual indicators of inclusivity, using inclusive language and embracing professional development. However, women and doctors both identify knowledge gaps among healthcare providers and the need for additional training opportunities to support effective inclusive practice.
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Affiliation(s)
- Ruby Grant
- School of Social Sciences, University of Tasmania, Hobart, Tasmania, Australia
| | - Meredith Nash
- School of Social Sciences, University of Tasmania, Hobart, Tasmania, Australia
| | - Emily Hansen
- School of Social Sciences, University of Tasmania, Hobart, Tasmania, Australia
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Grant R, Nash M. Young bisexual women's sexual health care experiences in Australian rural general practice. Aust J Rural Health 2019; 27:224-228. [DOI: 10.1111/ajr.12505] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 01/28/2019] [Accepted: 02/08/2019] [Indexed: 11/29/2022] Open
Affiliation(s)
- Ruby Grant
- School of Social SciencesUniversity of Tasmania Hobart Tasmania Australia
| | - Meredith Nash
- School of Social SciencesUniversity of Tasmania Hobart Tasmania Australia
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12
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Urry K, Chur-Hansen A. Who decides when people can have sex? Australian mental health clinicians' perceptions of sexuality and autonomy. J Health Psychol 2018; 25:2188-2199. [PMID: 30035634 DOI: 10.1177/1359105318790026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Sexuality is a central aspect of human experience but there is evidence that this is largely constrained, pathologised or ignored in mental health settings. We conducted in-depth interviews with 22 psychologists, psychiatrists and mental health nurses working across a variety of settings in four Australian cities. Sexuality was most often perceived as relevant in the mental health setting when it was simultaneously constructed as dangerous. Participants located this danger in sexual expression itself or within individuals who, because of mental illness, lacked the autonomy required to successfully engage in 'safe' sex. We discuss these findings and their implications for research and professional practice.
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