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Reproductive Health
Published in: Reproductive Health 1/2018

Open Access 01-12-2018 | Research

The no-go zone: a qualitative study of access to sexual and reproductive health services for sexual and gender minority adolescents in Southern Africa

Authors: Alex Müller, Sarah Spencer, Talia Meer, Kristen Daskilewicz

Published in: Reproductive Health | Issue 1/2018

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Abstract

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.
Footnotes
1
In an attempt to be precise about what the existing laws criminalise, activists and scholars specify that it is ‘same-sex activity’ that is contentious, rather than gay/ lesbian/ bisexual or transgender identity. We agree, and at the same time are aware that the term ‘sex’ (denoting physical attributes) is inappropriate to refer to gender diversity and gender non-conformity, and therefore also include the term ‘gender’ (denoting people’s identity, rather than their bodily characteristics).
 
2
While LGBT (lesbian, gay, bisexual, transgender) holds a lot of recognition value in Southern Africa, we consciously decided to rather use the term ‘sexual and gender minority adolescents’. This is not to assume that the experiences of people who identify as lesbian, gay, bisexual or transgender are the same – in fact, we are mindful of the heterogeneity, and the various, intersecting ways in which people who identify as LGBT are marginalized. Rather, we use this descriptor to highlight the commonalities of the source of this marginalization: heteronormative norms that result in the marginalization of all people whose identities or practices defy these norms.
 
3
We decided to retain the terminology used by organisations themselves, and employed by our participants, and thus use the term ‘LGBT’ when referring to organisations, or when it is used in direct quotes.
 
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Metadata
Title
The no-go zone: a qualitative study of access to sexual and reproductive health services for sexual and gender minority adolescents in Southern Africa
Authors
Alex Müller
Sarah Spencer
Talia Meer
Kristen Daskilewicz
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Reproductive Health / Issue 1/2018
Electronic ISSN: 1742-4755
DOI
https://doi.org/10.1186/s12978-018-0462-2

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