Healthcare providers' perspectives on pregnancy experiences among sexual and gender minority youth.

OBJECTIVE

To interview healthcare providers who serve adolescent populations to learn their perspectives on the factors that influence the continuum of sexual and gender minority (SGM) youth's pregnancy expaeriences, including decision-making about sex, relationships, and pregnancy.

METHODS

As part of the SexuaL Orientation, Gender Identity, and Pregnancy Experiences (SLOPE) Study, semi-structured interviews were conducted with 10 U.S.-based healthcare providers who had experience providing care for both SGM youth and pregnant youth. Interview questions examined providers' experiences caring for this population, including their perceptions of the risk and protective factors influencing SGM youth's pregnancy prevention, avoidance, and decision-making processes. Audio-recorded interview data were analyzed using immersion/crystallization and thematic analysis methods.

RESULTS

Three themes were identified from the healthcare providers' transcripts1) Cultural norms about adolescent pregnancy and sexuality, 2) Interpersonal relationships and family support, 3) Sex education, sexual and reproductive healthcare access, and sexual health equity.

CONCLUSION

In conjunction with sexual health education and healthcare access, healthcare providers described many social contexts-like peers, family, and communities-that interact with each other and with adolescent development to shape pre-conception practices and pregnancy decision-making processes. Future research, practice, and sexual health messaging about adolescent pregnancy would benefit from acknowledging the complex interplay among social identities and positions, structural prejudice, and the nuanced diversity in community and interpersonal factors-including those in sexual healthcare settings, like provider-patient communication and sex education delivery-that shape SGM youth's dating and sexuality experiences.