In the United States and abroad, the LGBTQ+ population has both historically and currently, suffered from a higher likelihood of poorer health outcomes than their heterosexual and cisgender counterparts due to stigma and discrimination (Alencar Albuquerque et al., 2016). While these health disparities have been well studied for the United States LGBTQ+ community as a whole, there is less understanding of what subgroups within this population may be disproportionately more susceptible to poorer health outcomes and risky behaviors, as well as, less understanding for the reasons behind such health outcomes and behaviors. One such subgroup is that of sexual minority women (SMW), or women who are sexually and/or romantically attracted to other women or who identify outside of heterosexual norms (Youatt, Harris, Harper, Janz, & Bauermeister, 2017). Preliminary studies have found that SMW are less likely than their sexual minority male and heterosexual female peers to have regular access to healthcare providers and are more likely to have negative experiences in healthcare settings, specifically in regards to sexual and reproductive healthcare (Riskind, Tornello, Younger, & Patterson, 2014). For these reasons, coupled with discrimination and risky sexual and health behaviors, SMW are a vulnerable population in need of social, political, and medical attention. This thesis aims to understand the causes and barriers SMW face when accessing sexual and reproductive health resources, as well as, provide direction for navigating such barriers on a multifactorial level. This research analyzes how hegemonic heteronormativity and sexism take root in (a) economic and political barriers in obtaining health insurance and health knowledge for SMW, (b) SMW patient ignorance of health risks and needs, (c) minimal to no medical provider training and understanding for SMW health risks, behaviors, and needs. Each barrier is addressed holistically; a novel approach necessary for the initial alleviation of such barriers to sexual and reproductive care and knowledge for SMW.

<p>Sexualitet är ett grundläggande behov hos människor och påverkar individens upplevelse av hälsa och välbefinnande. Skolan fungerar som en viktig arena för att främja unga vuxnas sexuella hälsa och sex- och samlevnadsundervisningen i skolan kan ha stor betydelse för unga vuxnas utveckling. Sex- och samlevnadsundervisning har varit obligatorisk i svenska skolor sedan år 1955. Trots det visar en kvalitetsgranskning av sex- och samlevnadsundervisningen i svenska skolor från år 1999 att kvaliteten på undervisningen är ojämn både mellan olika skolor och inom varje enskild skola. Syftet med denna studie var att studera hur sex- och samlevnadsundervisningen bedrivs i Sörmlands högstadie- och gymnasieskolor. En enkätundersökning har skickats ut till samtliga högstadie- och gymnasieskolor i Sörmland för att undersöka sex- och samlevnadsundervisningens omfattning, innehåll samt kvalitet. Resultatet visade att majoriteten av högstadie- och gymnasieskolorna bedriver sex- och samlevnadsundervisning och det vanligaste innehållet i undervisningen är STI, sexualitet, könsroller, relationer, kärlek samt preventivmedelsinformation. Hälften av skolorna samarbetar med en annan verksamhet i undervisningen och en tredjedel av skolorna har fastställda mål för hur sex- och samlevnadsundervisningen ska bedrivas. Slutsatsen är att undervisningen i vissa skolor bör utgå mer från ett främjande perspektiv och fler skolor behöver mål för sex- och samlevnadsundervisningen och utvärdera undervisningen i större utsträckning.</p> / <p>Sexuality is a fundamental need for humans and influences the individuals experience of health and well-being. The school serves as an important arena to promote adolescents sexual health and sex education in schools can have significant effects on adolescents` development. Sex education has been mandatory in Swedish schools since the year 1955. A quality review shows inequality in sex education in Swedish schools, both between schools and within each school. The aim of this study was to investigate how sex education is implemented in Sörmlands schools from grade seven to grade twelve. A questionnaire was sent out to all schools from grade seven to grade twelve in Sörmland to investigate sex educations extent, content and quality. The result showed that the majority of the investigated schools have sex education and the most common contents is STI, sexuality, gender roles, relationships, love and birth control information. Half of the schools collaborating with others in sex education and a third of the schools have set targets for the sex education. The conclusion is that sex education in some schools should be more of a promotion prospects and more schools need to set targets for the sex education and evaluate the sex education to a greater extent.</p>

Sexualitet och reproduktion utgör två centrala delar i människors liv och är integrerade i vår personlighet. Det är därför viktigt att från tidig ålder skapa en god grund för sexuell hälsa och välbefinnande. Att se ungdomar som handlingskraftiga aktörer och göra dessa delaktiga i diskussioner i en öppen dialog bidrar till ökade möjligheter för skapande och vidmakthållande av en hälsosam livsstil. Skolan utgör därför en viktig arena för hälsofrämjande och preventivt arbete då de flesta ungdomar kan nås där. I Kina infördes en obligatorisk nioårig skolgång för Kinas samtliga ungdomar år 1986 och år 2002 infördes även obligatorisk skolbaserad sexualundervisning.   Studien syftade till att undersöka hur kinesiska universitetsstudenters upplever sexualundervisning för ungdomar (10-19 år) i Kina samt behov av förändringar och pågående utvecklingstendenser. Kvalitativa intervjuer genomfördes med tre kinesiska universitetsstudenter och kontakt togs med en nyckelperson i Kina vilken översatte material enbart till denna studie.   Resultatet visade på att den skolbaserade sexualundervisningens utformning varierade inom Kina samt att dess implementering och utformning behöver stöttas mer.  Vidare framkom utvecklingsbehov av delaktighet och inflytande i sexualundervisningen. Även arbete för förbättrad kommunikation mellan lärare och elever behövs och ett salutogent synsätt behöver utvecklas.   Genom samarbete med andra länder, exempelvis med Sverige, kan dagens öppensinnade förändringsprocess ytterligare nyanseras. / Sexuality and reproduction are two central parts of human life and they are integrated into our personalities. It is therefore important to create a good foundation for sexual health and wellbeing from an early age. To see adolescents as “ready to act-individuals” and to make them more involved in open dialog discussions contributes to extended possibilities for creating and sustaining a healthy lifestyle. The school is therefore considered as an important arena for health promoting and preventive actions where most adolescents can be reached. An obligated nine years school based education was implemented in China 1986, and school based Sex education became obligated in 2002.   The study aimed to examine Chinese university student’s perceptions of Sexeducation for adolescents (10-19 years) in China and needs for changes and ongoing tendencies of development. Qualitative studies were conducted with three Chinese university students and contact was taken with a key person in China whom translated material for this study alone.   The result showed various constructions of school based Sexeducation in China and that its implementation and construction needs more support. It also showed a need for the development of influence and participation in the school based Sexeducation. A need for creating an improved communication between teachers and students was also expressed and a more salutogenic approach needs to be developed.   Through collaboration with other countries, for example Sweden, can today’s open-minded process of change benefit even more.

Sexualitet är ett grundläggande behov hos människor och påverkar individens upplevelse av hälsa och välbefinnande. Skolan fungerar som en viktig arena för att främja unga vuxnas sexuella hälsa och sex- och samlevnadsundervisningen i skolan kan ha stor betydelse för unga vuxnas utveckling. Sex- och samlevnadsundervisning har varit obligatorisk i svenska skolor sedan år 1955. Trots det visar en kvalitetsgranskning av sex- och samlevnadsundervisningen i svenska skolor från år 1999 att kvaliteten på undervisningen är ojämn både mellan olika skolor och inom varje enskild skola. Syftet med denna studie var att studera hur sex- och samlevnadsundervisningen bedrivs i Sörmlands högstadie- och gymnasieskolor. En enkätundersökning har skickats ut till samtliga högstadie- och gymnasieskolor i Sörmland för att undersöka sex- och samlevnadsundervisningens omfattning, innehåll samt kvalitet. Resultatet visade att majoriteten av högstadie- och gymnasieskolorna bedriver sex- och samlevnadsundervisning och det vanligaste innehållet i undervisningen är STI, sexualitet, könsroller, relationer, kärlek samt preventivmedelsinformation. Hälften av skolorna samarbetar med en annan verksamhet i undervisningen och en tredjedel av skolorna har fastställda mål för hur sex- och samlevnadsundervisningen ska bedrivas. Slutsatsen är att undervisningen i vissa skolor bör utgå mer från ett främjande perspektiv och fler skolor behöver mål för sex- och samlevnadsundervisningen och utvärdera undervisningen i större utsträckning. / Sexuality is a fundamental need for humans and influences the individuals experience of health and well-being. The school serves as an important arena to promote adolescents sexual health and sex education in schools can have significant effects on adolescents` development. Sex education has been mandatory in Swedish schools since the year 1955. A quality review shows inequality in sex education in Swedish schools, both between schools and within each school. The aim of this study was to investigate how sex education is implemented in Sörmlands schools from grade seven to grade twelve. A questionnaire was sent out to all schools from grade seven to grade twelve in Sörmland to investigate sex educations extent, content and quality. The result showed that the majority of the investigated schools have sex education and the most common contents is STI, sexuality, gender roles, relationships, love and birth control information. Half of the schools collaborating with others in sex education and a third of the schools have set targets for the sex education. The conclusion is that sex education in some schools should be more of a promotion prospects and more schools need to set targets for the sex education and evaluate the sex education to a greater extent.

Educating adolescents about sexual health in schools has been a controversial issue for the past 40-plus years. Multiple studies conducted by academic scholars, government agencies, and private organizations have concluded that adolescents receiving sexual education in schools typically make healthier decisions than adolescents not receiving a formal sexual health education, and adolescents participating in comprehensive programs make healthier choices than adolescents participating in abstinence programs. Texas school districts are not required to teach sexual education, but if they choose to do so, adolescents receive abstinence education. Texas adolescents also consistently report making more unhealthy sexual decisions than adolescents in other states. According to the social constructivist epistemology, learning occurs through social interactions with people, symbols, and tools. Interactions with various people, institutions, and information formats construct adolescents’ knowledge about sexual health. High school librarians who teach information literacy skills, who provide sexual health information resources in their collections, and who promote intellectual freedom improve adolescents’ knowledge about sexual health. The more informed adolescents are, the more likely they are to practice healthier sexual behaviors. Myriad factors encourage and discourage high school librarians from playing the role of sexual health information provider. This study explores the role high school librarians play as sexual health information providers within the framework of Role Theory. According to Role Theory, individuals exhibit predictable behaviors within a specific context based on socially constructed expectations. Multiple factors, both internal and external, may inhibit individuals from playing roles. District level library coordinators and high school principals share their perspectives about high school librarians playing this role and the factors influencing librarians’ willingness to do so. Data was collected through three rounds using the Delphi technique. Library coordinators and principals disagree about the role librarians play. Together participants identified fifteen motivators and five barriers to information provision. / text

I Sverige har förekomsten av klamydia ökat hos ungdomarna sedan 1997 och fortsatt stiga under 2000-talet. Den sexuella aktiviteten har förändrats till att ha fler tillfälliga partners och att skydda sig med kondom är inte alltid så självklart för de unga. Det kognitiva- och socioemotionella ssteme i hjärnan är inte färdigutvecklat hos tonåringarna vilket kan leda till spontana beslut och riskfyllt beteende. Syftet för denna litteraturstudie var att beskriva skolhälsovårdens hälsofrämjande omvårdnadsåtgärder för att påverka ungdomars sexuella risktagande. Event History Calendars, en metod för det individuella hälsosamtalet visade efter en månads postintervention en minskning av det sexuella riskbeteendet. Undervisning på gruppnivå är effektivt för att påverka ungdomars sexuella riskbeteende och för att höja åldern för den sexuella debuten. Men för yngre sexuellt aktiva tonåringar har dessa undervisningsmetoder ingen effekt. Metoder som stärker kommunikationen mellan de yngre tonåringarna och deras föräldrar har en skyddande effekt för utvecklingen av riskbeteenden. Familjeinterventionerna behöver undersökas närmare under svenska förhållanden. Metoder användbara i hälsosamtalen i skolhälsovården behöver också utvecklas i de svenska skolorna. Detta för att upptäcka de barn och ungdomar med behov av stöd. / The incidence of chlamydia in Swedish adolescents has increased in recent years. Sexual activity habits have changed and today´s teens have more partners and more casual contacts. Using condoms for protecting is not not always an obvious choice for the young. The cognitive ans socio-emotionell functions of the brain are not fully developed in young teens, and poor decision-making can and does lead to impulsive and risky beahaviors. The aim for this study of literature was to describe schhol health promotion nursing interventions to influence young peoples sexual risk-taking. Event History Calendars, a method used in individual health interviews, showed a reducation of risk behaviors after one month of post intervention. Teaching in groups is another effective method for influencing teens to reduce their risky behaviors and also leads to the additional positive outcome of raising the ages of sexual debut. Unfortunately these teaching methods have no positive effect on younger sexually active teens. A more productive methods for very young teens is to steengthen the communication between them and their parents. We need to examine closer the role of family interventions in Swedish schools as well as develope the methods shown to bee effective in health interviews in order to identify and assist children and young youth need of support.

There is no doubt that relevant and up-to-date elementary school curriculum is vital for the adequate education and socialization of youth, however, when a society is characterized by ideological pluralism and multiple visions of morality the debates over curriculum can be acrimonious and tempestuous. These debates are particularly heated when sex education is concerned since adults in Western society have a longstanding cultural discomfort with child and adolescent sexual knowledge and, more specifically, there is a strong belief that sexual knowledge compromises the “natural” innocence and ignorance of young people. This research focuses on a debate that occurred in Ontario in April and May of 2010 after the Government attempted to revise Health and Physical Education curriculum for grades 1-8, the subject that contains sex education. Following considerable backlash, the Ontario Premier shelved the proposed revisions a mere 54 hours after the curriculum was publicized. What led to this curriculum being received so poorly by the public and what were the contributing factors that led to this abrupt reconsideration? My research examines the debate that the new sex education curriculum produced and draws attention to the ways in which the deep seated anxieties of adults regarding adolescent and child sexual knowledge were able to overpower the voices of researchers and educational experts who were promoting the revisions. Some adults were concerned about the way that the curriculum presented a particularly liberal vision of sexual morality and argued that the new content would corrupt, mislead, and confuse youth. Though there were some individuals and groups who supported the revisions, arguing that they were relevant, necessary and overdue, their voices were not as organized or influential as the religious and social conservatives who dominated the debate. I argue that the proposed revisions to the Ontario sex education curriculum failed to gain public support because of the Government’s inability to adequately prepare for and mediate the Province’s competing liberal and conservative sexual ideologies. In my defense of the abandoned revisions, I explore how they failed to gain support not only because of the vociferous opposition of conservative religious groups who did not want to see a more liberal vision of sexual morality in the curriculum, but also due to a longstanding cultural discomfort with child and adolescent sexual knowledge and an unwillingness to fully affirm non-heterosexual identities and practices within the education system. / Thesis (Master, Sociology) -- Queen's University, 2011-06-07 14:50:24.526

Idag ska ungdomarna i högstadieskolan både hitta sig själva som individer och en sexualitet de känner sig trygga med, i ett samhälle där många och ofta motsägelsefulla bilder om sexualitet flödar. I dagens skola finns begrepp som kan kopplas till sex och samlevnad inskrivna i flera ämnes- och kursplaner och dessa ska finnas med under hela grundskolan. Flera studier visar att många elever upplever att sex och samlevnadsundervisningen är dålig, trots att skolan har en viktig roll som informatör. Syftet med min studie var att se om det finns några skillnader mellan lärare som arbetat olika länge som lärare med avseende på hur de upplever sex- och samlevnadsundervisningen. Frågeställningarna i studien var hur sex- och samlevnadsundervisningen planeras och genomförs, när den sker och hur styrdokumenten tolkas som är kopplade till skolans sex- och samlevnadsundervisning? Fyra kvinnliga pedagoger som är utbildade och undervisar i biologi har intervjuats. Två av dem har arbetat i mindre än tre år och två har arbetat i mer än fem år. Resultatet visar att det inte finns någon erfarenhetsbaserad skillnad på hur pedagogerna planerar undervisningen, innehållet i undervisningen eller när det kommer till tolkningar av läroplanen. När det gäller läroplanen finns istället en individbaserad skillnad där den pedagog som arbetat längst, har störst insikt i vad som står i läroplanen. Den största skillnaden mellan grupperna i studien visas när det kommer till pedagogernas egen utbildning i sex och samlevnad samt pedagogernas upplevelser av att utvecklaa. De pedagoger som arbetat kortast tid upplever att de fått väldigt lite utbildning inom området tillskillnad från de mer erfarna pedagogerna som upplever att de fått mer utbildning inom området. Samtidigt vill de mer erfarna pedagogerna utveckla sex- och samlevnadsundervisningen genom bättre materiel medan de mindre erfarna vill utveckla den genom att området bör synas mer under lärarutbildningen. / Today´s young people in upper elementary school today are supposed to both find themselves as individuals and find a sexuality they feel safe with, in a society where there are many and often contradictory images of sexuality. In today's school there are concepts linked to sex and relationships which are found in the curricula of several subjects and which should be discussed throughout elementary school. Several studies show that many students feel that sex education is poor, despite the fact that the school has an important role in communicating knowledge. The purpose of my study was to see if there are any differences between teachers with different levels of working experience with respect to how they experience teaching sex education. . The research questions in my study were how teaching of sex education is planned and implemented, when this teaching occurs and how the school´s policy documents related to sex education are interpreted? Four female teachers who are certified teachers and who teach biology, were interviewed. Two of them had worked less than three years as teachers and two had been working more than five years. The results show that there was no difference in how teachers plan teaching, teaching content and when it comes to interpretations of the curriculum related to the teachers´ working experience. In terms of curriculum, however, one individual-based distinction was detected, i.e. the teacher with the longest working experience as a teacher had the greatest knowledge of what is in the curriculum. The main difference between the two groups with different amounts of work experience had to do with the teachers 'own education in sex education and they felt about their own experiences in developing teaching. The educators who worked the shortest time felt that they had very little education in the field as opposed to the more experienced teachers who felt that they had more education in the area. At the same time, the more experienced teachers wanted to develop sex education through the use of better teachers’ materials while the less experienced teachers thought they needed a better education at the university.

När tonåringar utvecklar sin syn på sexualitet och samlevnad behöver de vuxenvärldens stöd och vägledning. Denna period av en människas liv präglas av upptäckande och utforskande vilket gör det betydelsefullt att ungdomar tillskansar sig kunskaper och utvecklar förståelse som bidrar till att de fattar hälsosamma beslut. Skolan fyller en viktig funktion i arbetet med att försöka ge alla ungdomar samma möjligheter till en god sexuell hälsa och är således en självklar arena för hälsofrämjande arbete. Syftet med denna studie är att ta del av pedagogers upplevelser av att undervisa inom sex- och samlevnad. Datainsamlingen genomfördes i form av sex semistrukturerade intervjuer med pedagoger inom olika undervisningsämnen på olika högstadieskolor i två kommuner. Resultatet tyder på att det finns en gemensam uppfattning om att sex - och samlevnadsundervisningen i skolan är viktig och dessutom antas ha positiva effekter för elevers sexuella hälsa. Det framgår dock att det förekommer skillnader i pedagogernas upplevelser av att kunna arbeta med sex – och samlevnad på ett strukturerat, medvetet och kreativt sätt. Hemmet och skolan beskrivs som två viktiga arenor. Föräldrar verkar ha en tilltro till pedagogers kompetens och pedagogerna själva tar sitt uppdrag som upplysare och vägvisare på stort allvar. / When teens develop their views on sexuality and relationships they need adult support and guidance. This period of a person's life is marked by discovery and exploration. Therefore it is important for young people to gain knowledge and develop understanding that contributes to making healthy decisions. The school plays an important role in efforts to try to give all young people the same opportunities for good sexual health education and is an obvious environment for health promotion. The purpose of this study is to take part of educators experiences of teaching in sex education. Data collection was conducted in the form of six semi-structured interviews with teachers in various subjects and at different secondary schools. The results suggest that there is a common perception that sex - and coexistence education in schools is important and assumed to have positive effects on students sexual health. However, it appears that there are differences in teachers' perceptions of being able to work with sex education in a structured , conscious and creative way. The home and the school are described as two important arenas . Parents seem to have a belief in teachers' skills and the teachers themselves take their mission as educators and guides very seriously.

Diss. Stockholm : Stockholms universitet, 2005.