Sex education needs of transgender, non-binary youth not met in standard curricula

The unique sex education needs of transgender and nonbinary youth are not met in standard curricula, and they often seek information elsewhere, putting them at risk for negative sexual health outcomes, researchers reported.

In a study presented during the virtual AAP National Conference & Exhibition, Samantha G. Haley, MD, a pediatrician at Woodinville Pediatrics in Woodinville, Washington, and colleagues interviewed 11 nonminor transgender or nonbinary (TNB) youth and five parents and five health care affiliates of TNB youth recruited from Seattle Children’s Gender Clinic.

Samantha G. Haley

“Our study found that TNB youth are turning to sources with high potential for bias and misinformation as their trusted sources of sex education, including peers, romantic partners and unfiltered online media,” Haley told Healio.

“Some topics that were mentioned by our study participants as ‘must haves’ for a sex ed curriculum serving this population are either missing from standard sex ed curricula, or are present but require trans-inclusive reframing to be relevant to this population — like under the ‘standard’ topic of communication and consent, discussing how to talk with a potential romantic partner about what words you feel comfortable using for your body parts,” Haley explained.

Study participants provided strategies for adapting language to be more inclusive of TNB identities — the use of ungendered, anatomy-based language; the use of autonomy in the choice of language used to describe their own bodies; and the use of narratives that emphasize self-determined TNB identities.

Haley provided three take-home messages for both parents and clinicians who deal with TNB youth:

• Be proactive and ask TNB youth what they are reading and hearing about puberty and sex. “You won’t be able to help them sift through misinformation if you don’t ask,” Haley said.

• Provide space for youth to discuss how dysphoria and gender-affirming interventions are impacting or may impact their romantic relationships.

• Use ungendered, anatomy-based language. “For example, say ‘people with uteruses’ instead of ‘women’ when talking about who should get pap smears,” Haley said. “Another example would be to say ‘penis’ instead of ‘male genitalia,’ and follow the patient’s lead on what words they prefer to use for their body parts.”

Haley and colleagues recommend that TNB youth look at content that includes standard sexual education topics that require trans-inclusive framing, topics specific to TNB youth, and topics absent from general curricula that warrant universal teaching.