Towards Equitable Sexual Health Care in BC: Centring the Voices of Cis and Trans Feminine Youth and Young Women in Policy and Practice

Equitable sexual health care access for cis and trans feminine youth and young women (15-29 years) outside major urban centres remains a pressing issue across Canada. In BC, rates of STIs, sexual violence, and unplanned pregnancies remain alarmingly high in a number of rural and mixed rural/urban centres, and are often a marker of a range of health and social inequities and gaps in sexual health care. Despite increasing attention to sexual health and calls to move away from a soley risk/ deficit-based model (eg. disease prevention) both in Canada and globally, there is a surprising dearth of research on uptake, barriers and facilitators for equitable sexual health care in Canada, or efforts to document and evaluate patient experiences with models of sexual health service provision. Drawing on mixed methods and feminist participatory-action research frameworks, we propose to conduct this community-based research project across rural and mixed urban/ rural communities on Vancouver Island. This 5-year study will address the following specific objectives to: Obj1: Characterize youth/ young women's sexual health service needs and experiences in interacting with sexual health services, across the sexual health domains, and variations by geographies and social identities; Obj 2: Document the lived experiences of evolving policy changes and socio-structural barriers and facilitators on access to equitable sexual health care among youth/ young women, and variations by sub-groups (e.g. Indigenous and other racialized youth/ young women, LGBTQ2S+ youth/ young women); Obj 3. Examine how different models of sexual health service provision (e.g. youth clinics; community clinics linked to secondary school clinics; or sexual health within primary care) are experienced by diverse youth and young women; Obj 4. Inform evidence-based development of community practice guidelines for equitable sexual health care for and with cis/trans feminine youth and young women in BC.