O0617 Oct.5: 2:34pm - Ideal Content and Best Practices for Sex Education Serving Transgender and Non-Binary Youth

Purpose:
Transgender and non-binary (TNB) youth face disparities in sexual health risks compared to cisgender peers. Comprehensive sex education has the potential to mitigate these risks; however, little research has explored sex education needs of TNB youth. This study aimed to understand deficits in sex education experienced by TNB youth, and to elicit recommendations for content and delivery of trans-inclusive sex education.

Methods:
We conducted 21 interviews with non-minor TNB youth (N=11) and with parents (N=5) and healthcare affiliates (N=5) of TNB youth recruited from Seattle Children’s Gender Clinic and TNB community listservs. Data was analyzed using theoretical thematic analysis.

Results:
Participants described key sources where TNB youth receive sexual health information: school curricula, medical practitioners, peers, romantic partners, online media, and parent-child conversations. Eight educational content areas were recommended as important for TNB youth: puberty-related gender dysphoria, non-medical gender-affirming interventions, medical gender-affirming interventions, consent and relationships, sex and desire, sexually transmitted infection prevention, fertility and contraception, and healthcare access. Participants recommended strategies for adapting language to be inclusive of TNB identities: using ungendered, anatomy-based language; facilitating linguistic self-determination (i.e. autonomy in choosing words used to describe their own bodies); and using narratives that emphasize self-determined TNB identities. Participants suggested that modeling trans-inclusive language has the potential to mitigate the negative impact of trans-exclusionary language TNB young people are likely to encounter elsewhere, and act as a mechanism for increasing their agency in making decisions about their bodies and sexual health.

Conclusions:
TNB youth have unique sex education needs that are not well covered in standard curricula, which leads them to seek information from potentially inaccurate sources and leaves them vulnerable to negative sexual health outcomes. Recommended content for this population includes standard sex education topics that require trans-inclusive framing (e.g. contraception), topics specific to TNB youth (e.g. gender-affirming medical interventions), and topics absent from standard curricula that warrant universal teaching (e.g. information on consent as it relates to sex acts aside from penile-vaginal sex). In addition to increasing access to accurate health information, sex education may be a contextually appropriate space to challenge cisnormative and binary assumptions about gender, particularly regarding language that is used to discuss anatomy and sexual health.