{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T01:39:48Z","timestamp":1792287588006,"version":"4.4.0"},"reference-count":46,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2023,4,14]],"date-time":"2023-04-14T00:00:00Z","timestamp":1681430400000},"content-version":"vor","delay-in-days":1291,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2019,10,1]],"date-time":"2019-10-01T00:00:00Z","timestamp":1569888000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2019,8,28]],"date-time":"2019-08-28T00:00:00Z","timestamp":1566950400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["jsm.jsexmed.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Transgender and non-binary (TNB) youth face disparities in sexual health risks compared with cisgender peers. Comprehensive sex education programs have the potential to result in delayed sexual debut, increased condom and contraceptive use, and reduced sexual risk-taking; however, little research has explored the specific sex education needs of TNB youth.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To use insights from TNB youth, parents of TNB youth, and healthcare affiliates to understand deficits in sex education experienced by TNB youth, and to elicit recommended content for a comprehensive and trans-inclusive sex education curriculum.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted 21 in-depth interviews with non-minor TNB youth (n\u00a0= 11) and with parents (n\u00a0=\u00a05) and healthcare affiliates (n\u00a0= 5) of TNB youth recruited from Seattle Children\u2019s Gender Clinic and local TNB community listerv readerships. Data was analyzed using theoretical thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcomes<\/jats:title>\n                    <jats:p>Participants described prior sex education experiences and content needs of TNB youth.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participants described 5 key sources where TNB youth received sexual health information: school curricula, medical practitioners, peers, romantic partners, and online media. Inapplicability of school curricula and variable interactions with medical practitioners led youth to favor the latter sources. 8 content areas were recommended as important in sex education for TNB youth: puberty-related gender dysphoria, non-medical gender-affirming interventions, medical gender-affirming interventions, consent and relationships, sex and desire, sexually transmitted infection prevention, fertility and contraception, and healthcare access.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Implications<\/jats:title>\n                    <jats:p>Dependence on potentially inaccurate sex education sources leaves TNB youth vulnerable to negative outcomes, including sexually transmitted infections, pregnancy, unsanitary\/unsafe sex toy use, and shame about their body or sexual desires.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Strengths &amp; Limitations<\/jats:title>\n                    <jats:p>Strengths included capturing perspectives of an underserved population using open-ended interview questions, which allowed topics of greatest importance to participants to arise organically. Limitations included a sample size of 21 participants, and racial and geographic homogeneity of youth and parent participants. Only 1 author identifies as TNB. One-on-one interview methods may have omitted participants who would otherwise have been willing to share their perspective in a more impersonal format.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study demonstrates that TNB youth have unique sex education needs that are not well covered in most sexual health curricula. Recommended content for this population includes standard sex education topics that require trans-inclusive framing (eg, contraception), topics specific to TNB youth (eg, gender-affirming medical interventions), and topics absent from standard curricula that warrant universal teaching (eg, information on consent as it relates to sex acts aside from penile-vaginal sex).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.jsxm.2019.08.009","type":"journal-article","created":{"date-parts":[[2019,10,1]],"date-time":"2019-10-01T17:14:22Z","timestamp":1569950062000},"page":"1834-1848","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":86,"title":["Sex Education for Transgender and Non-Binary Youth: Previous Experiences and Recommended Content"],"prefix":"10.1093","volume":"16","author":[{"given":"Samantha G.","family":"Haley","sequence":"first","affiliation":[{"name":"University of Washington, School of Medicine, Department of Pediatrics , Seattle, WA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana M.","family":"Tordoff","sequence":"additional","affiliation":[{"name":"University of Washington, Department of Epidemiology , Seattle, WA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alena Z.","family":"Kantor","sequence":"additional","affiliation":[{"name":"University of California Los Angeles, David Geffen School of Medicine , Los Angeles, CA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia M.","family":"Crouch","sequence":"additional","affiliation":[{"name":"Seattle Children\u2019s Research Institute, Center for Child Health, Behavior and Development , Seattle, WA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kym R.","family":"Ahrens","sequence":"additional","affiliation":[{"name":"University of Washington, School of Medicine, Department of Pediatrics , Seattle, WA , USA"},{"name":"Seattle Children\u2019s Research Institute, Center for Child Health, Behavior and Development , Seattle, WA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,10,1]]},"reference":[{"key":"2023041407073400400_","doi-asserted-by":"crossref","first-page":"1697","DOI":"10.1007\/s10508-016-0764-9","article-title":"Perceptions of sex, gender, and puberty suppression: A qualitative analysis of transgender youth","volume":"45","author":"Vrouenraets","year":"2016","journal-title":"Arch Sex Behav"},{"key":"2023041407073400400_","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1080\/14681811.2018.1439373","article-title":"\"More than boy, girl, male, female\": Exploring young people\u2019s views on gender diversity within and beyond school contexts","volume":"18","author":"Bragg","year":"2018","journal-title":"Sex Educ"},{"key":"2023041407073400400_","first-page":"26","article-title":"Imagining the future: Perspectives among youth and caregivers in the trans youth family study","volume":"64","author":"Katz-Wise","year":"2017","journal-title":"J\u00a0Couns Psychol"},{"key":"2023041407073400400_","doi-asserted-by":"crossref","first-page":"1184","DOI":"10.1542\/peds.2014-0772","article-title":"Psychological and medical care of gender nonconforming youth","volume":"134","author":"Vance","year":"2014","journal-title":"Pediatrics"},{"key":"2023041407073400400_","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1097\/MED.0000000000000236","article-title":"Research priorities for gender nonconforming\/transgender youth: Gender identity development and biopsychosocial outcomes","volume":"23","author":"Olson-Kennedy","year":"2016","journal-title":"Curr Opin Endocrinol Diabetes Obes"},{"key":"2023041407073400400_","doi-asserted-by":"crossref","first-page":"e20171683","DOI":"10.1542\/peds.2017-1683","article-title":"Health and care utilization of transgender and gender nonconforming youth: A population-based study","volume":"141","author":"Rider","year":"2018","journal-title":"Pediatrics"},{"key":"2023041407073400400_","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.jadohealth.2017.11.306","article-title":"Attitudes toward fertility and reproductive health among transgender and gender-nonconforming adolescents","volume":"63","author":"Chen","year":"2018","journal-title":"J\u00a0Adolesc Heal"},{"key":"2023041407073400400_","first-page":"67","article-title":"Transgender identity and experiences of violence victimization, substance use, suicide risk, and sexual risk behaviors among high school students\u201419 states and large urban school districts, 2017","volume":"68","author":"Johns","year":"2019","journal-title":"MMWR"},{"key":"2023041407073400400_","article-title":"Age of individuals who identify as transgender in the United States","author":"Herman"},{"key":"2023041407073400400_","doi-asserted-by":"crossref","first-page":"e20182162","DOI":"10.1542\/peds.2018-2162","article-title":"Ensuring comprehensive care and support for gender-diverse children and adolescents","volume":"142","author":"Rafferty","year":"2018","journal-title":"Pediatrics"},{"key":"2023041407073400400_","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s10461-007-9299-3","article-title":"Estimating HIV prevalence and risk behaviors of transgender persons in the United States: A systematic review","volume":"12","author":"Herbst","year":"2008","journal-title":"AIDS Behav"},{"key":"2023041407073400400_","article-title":"The report of the 2015 U.S. Transgender Survey","author":"James"},{"key":"2023041407073400400_","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1089\/vio.2017.0041","article-title":"Intimate partner violence among transgender youth: Associations with intrapersonal and structural factors","volume":"5","author":"Goldenberg","year":"2018","journal-title":"Violence Gend"},{"key":"2023041407073400400_","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1016\/j.jadohealth.2005.03.023","article-title":"Overlooked, misunderstood and at-risk: Exploring the lives and HIV risk of ethnic minority male-to-female transgender youth","volume":"38","author":"Garofalo","year":"2006","journal-title":"J\u00a0Adolesc Heal"},{"key":"2023041407073400400_","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1007\/s10508-011-9748-y","article-title":"Recalled sexual experiences in childhood with older partners: A study of Brazilian men who have sex with men and male-to-female transgender persons","volume":"41","author":"Carballo-Di\u00e9guez","year":"2012","journal-title":"Arch Sex Behav"},{"key":"2023041407073400400_","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1080\/15532739.2016.1216345","article-title":"Prevalence of pregnancy involvement among Canadian transgender youth and its relation to mental health, sexual health, and gender identity","volume":"17","author":"Veale","year":"2016","journal-title":"Int J Transgenderism"},{"key":"2023041407073400400_","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1016\/j.jadohealth.2015.04.027","article-title":"Baseline physiologic and psychosocial characteristics of transgender youth seeking care for gender dysphoria","volume":"57","author":"Olson","year":"2015","journal-title":"J\u00a0Adolesc Heal"},{"key":"2023041407073400400_","article-title":"Sex and HIV Education","author":"Guttmacher Institute"},{"key":"2023041407073400400_","article-title":"Bill Text - AB-329 Pupil instruction: sexual health education"},{"key":"2023041407073400400_","article-title":"School health profiles 2016: Characteristics of health programs among secondary schools. Atlanta: Centers for Disease Control and Prevention; 2017","author":"Brener"},{"key":"2023041407073400400_","article-title":"The 2017 National School Climate Survey: The experiences of lesbian, gay, bisexual, transgender, and queer youth in our nation's schools","author":"Kosciw"},{"issue":"4","key":"2023041407073400400_","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/14681811.2012.677211","article-title":"Sexuality education school policy for Australian GLBTIQ students","volume":"12","author":"Jones","year":"2012","journal-title":"Sex Educ"},{"key":"2023041407073400400_","article-title":"Informing the future sex and relationships education curriculum in Wales","author":"Renold"},{"key":"2023041407073400400_","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.1007\/s10508-017-1082-6","article-title":"Sexual health risk behavior disparities among male and female adolescents using identity and behavior indicators of sexual orientation","volume":"48","author":"Paul Poteat","year":"2019","journal-title":"Arch Sex Behav"},{"key":"2023041407073400400_","first-page":"1832","article-title":"Exploring first sexual intercourse, sexual orientation, and sexual health in men","volume":"64","author":"Dewaele","year":"2017","journal-title":"J\u00a0Homosex"},{"key":"2023041407073400400_","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1023\/A:1002058505138","article-title":"Sexual identity trajectories among sexual-minority youth: Gender comparisons","volume":"29","author":"Savin-Williams","year":"2000","journal-title":"Arch Sex Behav"},{"key":"2023041407073400400_","article-title":"Emerging evidence, lessons and practice in comprehensive sexuality education: A global review","author":"UNESCO"},{"key":"2023041407073400400_","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1016\/j.amepre.2011.11.006","article-title":"The effectiveness of group-based comprehensive risk-reduction and abstinence education interventions to prevent or reduce the risk of adolescent pregnancy, human immunodeficiency virus, and sexually transmitted infections","volume":"42","author":"Chin","year":"2012","journal-title":"Am J Prev Med"},{"key":"2023041407073400400_","article-title":"A\u00a0call to action: LGBTQ youth need inclusive sex education"},{"key":"2023041407073400400_","article-title":"International technical guidance on sexuality education","author":"UNESCO"},{"key":"2023041407073400400_","author":"United Nations Human Rights. Born Free and Equal: Sexual Orientation and Gender Identity in International Human Rights\u00a0Law. Available at:"},{"key":"2023041407073400400_","first-page":"654","article-title":"Trans people\u2019s experience of sexuality in the netherlands: A pilot study","volume":"61","author":"Doorduin","year":"2014","journal-title":"J\u00a0Homosex"},{"key":"2023041407073400400_","doi-asserted-by":"crossref","first-page":"e20162283","DOI":"10.1542\/peds.2016-2283","article-title":"Sexual and romantic experiences of transgender youth before gender-affirmative treatment","volume":"139","author":"Bungener","year":"2017","journal-title":"Pediatrics"},{"key":"2023041407073400400_","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1097\/00004583-200104000-00017","article-title":"Adolescents with gender identity disorder who were accepted or rejected for sex reassignment surgery: A prospective follow-up study","volume":"40","author":"Smith","year":"2001","journal-title":"J\u00a0Am Acad Child Adolesc Psychiatry"},{"key":"2023041407073400400_","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1097\/00004583-199702000-00017","article-title":"Sex reassignment of adolescent transsexuals: A follow-up study","volume":"36","author":"Cohen-Kettenis","year":"1997","journal-title":"J\u00a0Am Acad Child Adolesc Psychiatry"},{"key":"2023041407073400400_","first-page":"220","article-title":"Feasibility, acceptability, and initial efficacy of an online sexual health promotion program for LGBT youth: The queer sex ed intervention","volume":"52","author":"Mustanski","year":"2015","journal-title":"J\u00a0Sex Res"},{"key":"2023041407073400400_","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1007\/s13178-018-0326-0","article-title":"\u201cI have no idea what\u2019s going on out there\u201d: Parents\u2019 perspectives on promoting sexual health in lesbian, gay, bisexual, and transgender adolescents","volume":"15","author":"Newcomb","year":"2018","journal-title":"Sex Res Soc Policy"},{"key":"2023041407073400400_","doi-asserted-by":"crossref","first-page":"916","DOI":"10.1001\/jamapediatrics.2018.1799","article-title":"Efficacy of an empowerment-based, group-delivered HIV prevention intervention for young transgender women","volume":"172","author":"Garofalo","year":"2018","journal-title":"JAMA Pediatr"},{"key":"2023041407073400400_","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1186\/s12889-017-4734-5","article-title":"Project LifeSkills\u2014A randomized controlled efficacy trial of a culturally tailored, empowerment-based, and group-delivered HIV prevention intervention for young transgender women: Study protocol","volume":"17","author":"Kuhns","year":"2017","journal-title":"BMC Public Health"},{"key":"2023041407073400400_","first-page":"1","article-title":"Sex education and transgender youth: \"Trust means material by and for queer and trans people.\"","volume":"1811","author":"Bradford","year":"2018","journal-title":"Sex Educ"},{"issue":"2","key":"2023041407073400400_","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using thematic analysis in psychology","volume":"3","author":"Braun","year":"2006","journal-title":"Qual Res Psychol"},{"key":"2023041407073400400_","article-title":"Sex ed for the real world","author":"Scarleteen"},{"key":"2023041407073400400_","article-title":"Autostraddle"},{"key":"2023041407073400400_","article-title":"Rookiemag"},{"key":"2023041407073400400_","article-title":"Serious Trans Vibes","author":"Labelle"},{"key":"2023041407073400400_","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1080\/14681811.2015.1080678","article-title":"School experiences of transgender and gender diverse students in Australia","volume":"16","author":"Jones","year":"2016","journal-title":"Sex Educ"}],"container-title":["The Journal of Sexual Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1743609519313724?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1743609519313724?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/jsm\/article-pdf\/16\/11\/1834\/49887586\/jsm_16_11_1834.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jsm\/article-pdf\/16\/11\/1834\/49887586\/jsm_16_11_1834.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,21]],"date-time":"2023-09-21T00:35:29Z","timestamp":1695256529000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jsm\/article\/16\/11\/1834\/6980636"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,1]]},"references-count":46,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2019,10,1]]},"published-print":{"date-parts":[[2019,11,1]]}},"URL":"https:\/\/doi.org\/10.1016\/j.jsxm.2019.08.009","relation":{},"ISSN":["1743-6109","1743-6095"],"issn-type":[{"value":"1743-6109","type":"electronic"},{"value":"1743-6095","type":"print"}],"subject":[],"published-other":{"date-parts":[[2019,11]]},"published":{"date-parts":[[2019,10,1]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Sex Education for Transgender and Non-Binary Youth: Previous Experiences and Recommended Content","name":"articletitle","label":"Article Title"},{"value":"The Journal of Sexual Medicine","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jsxm.2019.08.009","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2019 The Authors. Published by Elsevier Inc. on behalf of the International Society for Sexual Medicine.","name":"copyright","label":"Copyright"}]}}