Previous research shows that LGBTQ+ youth are over-represented in out-of-home care and that especially transgender andnon-binary youth face challenges during their placement. These challenges stem from, among other factors, the lack ofknowledge and competence of professionals regarding the unique needs of transgender and non-binary youth. In Sweden,there are policies that aim to protect transgender and non-binary youth from discrimination and to promote their sexualand reproductive health and rights, and an increasing number of residential homes claim to have LGBTQ competencewhen competing for placements. However, it is unclear how this affects the everyday experiences of trans and non-binaryyouth at residential homes. The purpose of this study is to investigate the practices and challenges of clinical social workers at residential care homes when working with gender identity and sexual health issues among young transgender andnon-binary youth. Eight semi-structured interviews focusing on professionals’ knowledge and experiences were conductedand analysed using reflexive thematic analysis. Four themes emerged: i) Knowledge being a personal matter; ii) Heteronormativity and binarity creating consequences; iii) Handling discrimination and harassments; and iv) Creating a trustfulalliance. The results show that knowledge is a personal matter, and social work professionals seek the knowledge theyneed instead of receiving it in education or training. The contextual heteronormativity and binarity creating consequencesat the residential care home pose challenges for social workers and they have to find creative ways to support transgenderand non-binary youth and address the harassments and discrimination that these youth face. Moreover, the social workersshare their strategies regarding how they are creating a trustful alliance. Overall, they identify significant challenges todeveloping clinical social work that is affirming of transgender and non-binary youth.

The use of alcohol or illicit substances by youths may be related to sexual motives and experiences. Accordingly, child welfare workers need to address young people's sexuality in their investigative work. In this study, we have examined the significance of different social categories, namely gender and sexual orientation, when child welfare workers assess young people with a substance use and their related sexual health. Fifteen child welfare workers were recruited through a strategic sampling to participate in semi-structured interviews, which were analysed using thematic content analysis. The results consist of three sub-themes: Sexually vulnerable girls; Boys as perpetrators; and Unseen LGBTQ+ youth. Together, these sub-themes constitute an overarching theme where the heterosexual matrix appears to be the interpretative framework when investigating a problematic substance use. The suggested implications for practice include education in sexual and reproductive health and rights for child welfare workers aiming to achieve an equitable assessment process for all youth with a problematic substance use. 

Socialsekreterares förståelse av kön, sexuell läggning och sexuell hälsa i utredningar av unga med substansmissbruk 

Ungas substansanvändning kan ibland relateras till sexuella motiv och erfarenheter. Det är därför av vikt att socialsekreterare adresserar dylika frågor i barnavårdsutredningar som är fokuserade på ungas eventuella missbruksproblematik. I denna studie har vi därför undersökt hur olika sociala kategorier – kön och sexuell läggning – relateras till ungas sexuella hälsa, men också hur det får betydelse i utredningar av unga med missbruk. Femton socialsekreterare har intervjuats med stöd av en semi-strukturerad intervjuguide, vartefter resultatet analyserats med hjälp av en tematisk innehållsanalys. Det slutgiltiga resultatet ledde fram till tre sub-teman: sexuellt sårbara tjejer; killar som förövare; osynliga HBTQ+ -ungdomar. Dessa tre teman bildar tillsammans ett övergripande tema; den heterosexuella matrisen fungerar som tolkningsram i utredningsarbete av ungas substansmissbruk. Implikationer för praktiken innefattar bland annat utbildning i sexuell och reproduktiv hälsa och rättigheter (SRHR) för socialsekreterare inom den sociala barnavården i syfte att säkerställa jämlika utredningsprocesser för alla unga med substansmissbruk. 

Young people with substance use problems often have an early sexual debut, an increased risk of sexually transmitted infections and unplanned pregnancies, and a high risk of experiencing sexual violence. At the same time, according to the national action plan on sexual and reproductive health and rights (SRHR), the social services in Sweden have an important role in addressing sexual health in various contexts, such as in child welfare investigations. Therefore, this study has investigated how Swedish child welfare workers understand and relate to sexual health issues in child welfare investigations regarding young people with substance use problems. Following a strategic sampling, 15 child welfare workers were interviewed. The interviews were examined with a thematic content analysis with results showing that sexual health issues represented an area where knowledge was lacking. This was largely connected to that the child welfare workers had not been taught about SRHR in their bachelor’s degree nor in their continued education within the child welfare system. As a result of this, they often developed their own individual, professional approach for assessing sexual health matters, guided by the principle of “not investigating more than necessary”. When addressing sexual health in their assessment work, the child welfare workers primarily focused on risk, vulnerability and exposure. Not assessing young peoples’ sexual health was seen as protecting the right to confidentiality and privacy. In summary, this meant that young people with a problematic substance use were seldom given opportunities to talk about their sexual health, and especially not about positive sexual experiences related to their substance use.

With a phenomenological approach, we explored transgender and non-binary people’s strategies to experience sexual well-being. Ten self-reports (seven interviews and three written texts) were analyzed, and the analysis resulted in six themes. The first three (Affirming oneself, Having access to care, and Being respected as one’s gender) were strategies for sexual well-being realized through affirming one’s identity, receiving the gender-confirming care wanted, and having one’s gender identity respected by others. The other three themes (Masturbating and fantasizing, Communicating and being open, and Being sexually free in queer spaces) were strategies for one aspect of sexual well-being—pleasure. The results describe strategies that all can learn from: the need to accept and appreciate oneself, not just adapt to gender norms of bodies and behaviors, and to communicate. In addition, it illuminates that being norm-breaking, or stepping out of the gendered paths presented to you, appears to provide new opportunities for people to learn what they enjoy, and this could lead to a broader repertoire of pleasurable sexual practices—practices that take bodily prerequisites into account

Objective: Young people are prioritized regarding the promotion and safeguarding of sexual and reproductivehealth and rights – SRHR. In Sweden, the school is seen as an important arena with members of the school healthcare or SHC team as vital actors in this work. This study explored SRHR-related work in SHC teams in Sweden.

Methods: Within an explorative qualitative design, structured interviews were conducted with 33 nurses, counsellors, SHC unit managers and headmasters. Reflexive thematic analysis was applied, and two main themesfound.

Results: SHC team members see SRHR as an urgent topic, but address it only ‘when necessary’, not systematically– and they experience a shortage of guidance and cooperation regarding SRHR-related work. Even in a countrywith agreement on the importance of SRHR for all and on providing holistic comprehensive sex education inschools, young people are left to chance – i.e., to the SRHR competence in the professionals they meet.

Conclusion: SHC team members in Sweden see SRHR as an urgent topic but do not address it systematically.Moreover, they experience a shortage of guidance for their work. To avoid any professional stress of conscienceand for equitable school health care regarding SRHR to be realized, research-informed policy needs to underlinesystematic, comparable and proactive practice.

The aim of this study is to explore the current scientific evidence for using the twelve-step method as a treatment method for sex addiction and compulsive sexual behavior (disorder). Peer-reviewed empirical articles on the twelve-step method and sex addiction and compulsive sexual behavior (disorder) written in English, Danish, Norwegian, or Swedish, retrievable in selected databases were included. No limits were set on publication date or study design. The systematic review resulted in eight empirical studies which were read and assessed according to the Mixed Methods Appraisal Tool. The results were inconclusive, and we found only three articles of high quality, where the samples were composed mainly by men, which indicate that peer-therapy in combination with individual therapy might be beneficial. That twelve-step treatment rests heavily on the idea of sex addiction was unproblematized in most of the publications. Overall, the findings raise issues concerning who benefits from this treatment.

Although a growing body of literature has focused on the experience of young people with migration experience with Swedish sexual and reproductive health (SRH) services, there is a lack of deep qualitative exploration. The study aims to explore the encounters of young people with migration experience with SRH services and their understandings of factors that affect their use of these services. The findings of this study were drawn from 18 interviews conducted between October 2021 and May 2023 in Southern Sweden. A combination of convenient and snowball sampling strategies was used. Participants included in the study self-identified as Middle Eastern, migrated to Sweden, and were aged between 17 and 26. Data were analyzed using reflexive thematic analysis approach. Three themes were generated during the analysis. The first SRH services: dual perceptions and experiences shows how participants had ambivalent perceptions of SRH services, mainly the youth clinic. Some perceived the youth clinic as a stigmatized place associated with shame and SRH concerns like unwanted pregnancy and sexually transmitted infections, while others viewed the youth clinic as a safe space. The negative perceptions along with the difficulties with accessing the youth clinic contributed to low service use. The second Sexuality education: an eye-opener or a joke? reflects participants' both positive and negative experiences and attitudes when receiving sexuality education in schools. The third SRH information: beyond formal services and education captures participants' ways of accessing SRH information that go beyond information provided at the traditional SRH services and sexuality education in schools. These sources include the family, friends, and the internet. The study points to the need for multicomponent strategies to improve the accessibility of SRH services and draws attention to the importance of challenging norms related to Swedishness in sexuality education to foster the engagement of youth with migration experience and ensure their sexual citizenship.

Young men in jail and prison are vulnerable regarding sexual health and the fulfilment of their sexual rights. As a response to this, the Swedish Association for Sexuality Education (RFSU) has been providing sex education to young, incarcerated men, via a project initiated by and in cooperation with the Swedish Prison and Probation Services (SPPS). This article is a qualitative exploration of how RFSU educators experienced their work, and of how staff within SPPS experienced the initiative. Eight RFSU educators, and six persons working within SPPS were interviewed, and a thematic analysis was conducted. Overall, the experiences described by RFSU educators and by SPPS staff were similar, they regarded sex education sensitive to what young men wanted to discuss as valuable and the project feasible. Future improvement areas include strategies on how to handle toxic masculinity among young men in jail and prison. Additionally his, the different aims that the organisations RFSU and SPPS have, and how young men navigate them, must be acknowledged. Young men’s voices are missing in this study, and examining their experiences of the sex education in future work would be valuable. 

Young LGBTQ+ people are over-represented in various forms of state care. They experience hardships during their placements and staff competence in addressing specific needs among LGBTQ+ youth is lacking. In this article, we investigate whether and how LGTBQ+ issues are considered and described in digital marketing for state care providers. The material consists of the homepages of residential care homes and secure state care institutions, which we analyse using critical discourse analysis. The results show that LGBTQ+ issues are largely invisible. Of the approximately 1,000 existing state care providers, only twenty stated that they worked with or had competence in LGBTQ+ issues. Among these, no secure state care institution offered LGBTQ+ competence at the time of the study. The descriptions of how care providers work with LGBTQ+ issues are characterised by heteronormativity where there is a mix of two types of language on the homepages regarding LGBTQ+ youth; on the one hand, a heteronormative, traditional description based on a binary understanding of gender; and, on the other, an LGBTQ+ inclusive language is used. However, the LGBTQ+ affirmative language has been imposed upon the traditional rather than being integrated into it, which comes across as superficial and unclear. International studies show that LGBTQ+ youth are over-represented in various forms of state care. Using critical discourse analysis, we investigated how LGBTQ+ youth, as a target group, are described and how LGBTQ+ competence is presented on the home pages of residential care homes and secure state care institutions for young people in Sweden. The results show that LGBTQ is largely invisible. Of the approximately 1,000 existing residential care homes, only 20 stated that they worked with or had competence in LGBTQ+ issues. No secure state care institution offered LGBTQ+ competence at the time of the study.

Background

School-based sexuality education is a core component of securing young people’s right to attain health equity regarding sexual and reproductive health and rights. This paper aims to explore how perceived knowledge (sufficient or insufficient) of taking care of one’s sexual health is associated with knowledge gained from school-based sexuality education and social determinants.MethodsThe data material is drawn from a population-based survey conducted in Sweden in 2015. The survey had 7755 respondents and a response rate of 26%. To explore the aim descriptive statistics and logistic regression models were used.

Results

Our results show that perceived insufficient knowledge from school-based sexuality education was associated with higher odds of reporting not being able to take care of one’s sexual health. The highest significant excess risk for insufficient knowledge was found among young people from sexual minorities.

Conclusions

Young people in Sweden do not have equal abilities to receive knowledge needed to take care of their sexual health and thus attain sexual health literacy. There is an unequal distribution of perceived knowledge, and LGBTQI+ youth particularly face barriers in using school-based sexuality education as a resource for sexual health literacy.