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. 

Social workers often lack formal training in sexual health issues, both in terms of their academic education and through knowledge-enhancing initiatives in practice. This lack of knowledge is noteworthy, given that child welfare services frequently work with young people who are particularly vulnerable in terms of sexual health, such as those with problematic substance use. The purpose of this study is to investigate how child welfare assessments of young people with substance use problems relate to issues of sexual health. A total of 15 semistructured interviews were conducted with investigating child welfare workers and front-line managers, which serve as the foundation for two academic papers.

The first paper focused on how sexual health issues were understood and managed within child welfare investigations, concluding that sexual health was not regarded as a distinct area of knowledge. Instead, child welfare workers viewed sexual health issues as part of other established domains, such as problematic substance use, gender-based violence, or delinquency. Consequently, issues interpreted as more explicit sex-related issues were not seen as the responsibility of the child welfare system, but were primarily referred to healthcare professionals.

The second paper examined how youths’ gender, sexual orientation, and sexual health related to issues of sexual health through the child welfare investigation process. The results shows that the child welfare services adopt a relatively narrow as well as heteronormative approach to sexual health and sexuality; girls were seen as potential victims of sexual assault, while boys were viewed as perpetrators of sexual violence. Young LGBTQ individuals, however, were often unseen due to their nonconformity to traditional gender norms that usually characterize the assessment work of the child welfare services.

Together, the two papers highlights how the child welfare services lacks a structure to develop and utilize in-depth knowledge in the field of sexual health. This was particularly evident in how the sexual health of young people often became an issue for individual social workers who were personally interested and/or committed to supporting young people in these matters, rather than seeing the organization as a whole as responsible for supporting young people’s personal conditions necessary for good sexual health. 

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.

Substance abuse and sexual ill health often go hand in hand. Despite this, no previous studies have investigated whether, and if so how, young people’s sexuality is given meaning in child welfare assessments due to suspected substance abuse. To investigate this, 15 child welfare workers in Sweden were recruited for a semi-structured interview through a strategic selection. The interviews were examined with the support of thematic analysis, which resulted in an overarching theme showing a lack of an area of knowledge. The social workers stated that they had not been trained in SRHR during their basic training or through further training in the roles as child welfare workers. However, this did not mean that they dismissed sexual health matters, rather that they developed individual approaches to face such questions. A common and recurring motto was “to not investigate more than necessary”, which meant that social workers often focused on risk and vulnerability in relation to substance use and related life conditions, and they also related to other areas of knowledge such as violence and crime. The social workers often referred to young persons’ right to confidentiality and privacy when it came to talking about positive aspects of young people’s sexuality, which meant that young people were rarely given space to talk about possible lustful connections between substance use and their sexuality. Overall, the lack of an area of knowledge within the child welfare services illuminates a need for targeted educational efforts toward child welfare professionals, efforts that are in line with the Swedish national strategy regarding sexual and reproductive health and rights for all.

Sex dolls are a complex phenomenon with several diverse possible emotional, sexual and therapeutic uses. They can be part of a broad variety of sexual practices, and also function as a sexual aid. However, the media discourse on sex dolls first and foremost concerns how we perceive the relationship between intimacy and technology. A critical discourse analysis of the Swedish media discourse on sex dolls reveals six themes which dominate the discourse: (a) the definition of what a human being is; (b) a discourse on the (technological and existential) future; (c) a social effort; (d) a loveless phenomenon; (e) men’s violence against women; and (f) pedophilia. Accordingly, this discourse is very conservative and normative in its view of sexuality, technology, and humanity. Overall, the dominant themes do not provide any space for positive effects of technology on human sexuality, and if they do, it is usually as a substitute for something else.