Current sex education curricula don’t always address the needs of transgender and non-binary (TNB) youth. However, a recent series of interviews with TNB youth, parents, and healthcare providers suggests topics that programs might include.
The study, published online last month in the Journal of Sexual Medicine, involved 11 TNB youth aged 18 to 26 (six transgender men, three transgender women, and two non-binary youth), five parents (all cisgender women), and five healthcare affiliates. Interviews lasted between 30 and 60 minutes and included questions about sex education sources and suggested content for sex education programs.
The participants reported that, for the most part, gender and sexual orientation were not adequately addressed in school sex health curricula. “It was just for cis[gender], straight people,” one participant remarked. “If you asked about it, you tended to be ignored.”
Youth preferred getting sex health information from their peers, romantic partners, and online media, although these sources were not always deemed reliable or accurate. Most youth did not see healthcare providers as a “top sex education resource.”
When asked about recommended content for sex education programs, several themes and subtopics were noted:
Puberty-related gender dysphoria
“Youth emphasized the importance of talking to kids early about puberty to normalize dysphoria as a valid feeling,” the authors wrote. Other recommended topics were puberty blockers, gender-affirming interventions, and menstrual suppression.
Non-medical gender-affirming interventions
Specific strategies, such as the use of binders, packers, and stand-to-pee devices were discussed. Product safety and associated hygiene were other concerns.
Medical gender-affirming interventions
Many participants felt that pubertal blockers, hormone therapy, and gender-affirming surgeries were important topics for sex education programs.
Consent and relationships
“Youth recommended that consent and boundary setting should be a key part of sex education for TNB youth,” the authors said, adding that coping with emotions, communication between partners, and disclosure of TNB identity were other essential components.
Sex and desire
Some participants pointed out the diversity of sexual attraction and that some people are asexual or decide not to pursue sexual relationships.
Youth reported wanting to know more about the “mechanics of sex” as well. “A lot of people don’t know how sex works between two trans people, or a trans and a cis person,” said an 18-year-old transgender man. The safe use of sex toys was another interest.
Learning about sexually transmitted infections (STIs) in a nonjudgmental way was important to some participants. STI testing, pre-exposure prophylaxis, and post-exposure prophylaxis, barrier protection were also noted.
Contraception and fertility
While youth wanted to learn about a variety of birth control methods, parents and healthcare providers expressed concerns about future fertility.
Participants said it was essential for TNB youth to know how to select providers, talk openly about sexual health issues, and navigate the healthcare system. “[A] ‘negotiating with your doctor’ class would be great,” said a 26-year-old non-binary youth.
Some of the above topics, such as STI prevention and contraception, are included in typical sex health curricula, but could be revised to be more “trans-inclusive,” the authors wrote.
They recommended future research on developing and delivering such programs.
The Journal of Sexual Medicine
Haley, Samantha G., MD, et al.
“Sex Education for Transgender and Non-Binary Youth: Previous Experiences and Recommended Content”
(Full-text. Published online: October 1, 2019)