禁区：南部非洲性少数和性别少数青少年获得性健康和生殖健康服务的定性研究。
The no-go zone: a qualitative study of access to sexual and reproductive health services for sexual and gender minority adolescents in Southern Africa.
机构信息
Gender, Health and Justice Research Unit, University of Cape Town, Observatory, Cape Town, South Africa.
出版信息
Reprod Health. 2018 Jan 25;15(1):12. doi: 10.1186/s12978-018-0462-2.
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.
背景
青少年有重要的性健康和生殖健康需求。然而，复杂的法律框架和社会对青少年性行为的态度，包括医疗保健提供者的价值观，都限制了青少年获得性健康和生殖健康服务的机会。这些法律和社会态度往往与性少数群体和性别少数群体相悖。现有文献假设青少年自认为是异性恋者，并且只与异性伴侣进行（异性恋规范的）性活动，因此，对于性少数群体和性别少数群体青少年的需求是否以及如何得到满足，知之甚少。
方法
在本文中，我们分析了来自马拉维、莫桑比克、纳米比亚、赞比亚和津巴布韦的与青少年、性少数群体和/或性健康和生殖健康权利工作的组织的代表进行的五十次深入定性访谈的数据。
结果
这些国家的性少数群体和性别少数群体青少年在寻求性健康和生殖健康服务时面临双重边缘化：作为青少年，他们在寻求 LGBT 组织的服务时面临障碍，因为这些组织担心被描绘成“同性恋招募者”，而与此同时，他们也被异性恋规范的青少年性健康和生殖健康服务所排斥。这些服务障碍同样归因于对同性伴侣之间自愿的性行为的实际和感知的刑事定罪，无论其年龄大小。
讨论/结论：将同性伴侣之间的自愿性行为定罪的法律以及对性少数群体和性别少数群体的社会污名化，使得可能提供的合法的性健康和生殖健康服务变得无效。青少年的性活动的年龄相关的污名化进一步加剧了这种情况，使得性少数群体和性别少数群体青少年无法获得有关其性取向和性健康以及性健康和生殖健康服务的必要信息。
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