Beyond The Realms Of Pregnancy – How Conversations About Contraception Can Contribute To Improving The Health Of Sexual Minority Women

Background: Sexual minority women (SMW) face several disparities within healthcare and health outcomes. SMW and individuals assigned female at birth (AFAB) share many of the same reproductive and sexual health concerns as heterosexual, cisgender women (Eliason & Schope, 2001). Despite this, little is known about the barriers SMW face accessing contraceptive health care when there is no pregnancy risk present. Furthermore, there is limited research regarding how discussing contraception with SMW can improve their health and well-being.

Aim: This research aims to identify the barriers in place for SMW and AFAB individuals when accessing contraception, particularly when they are not at risk of pregnancy. Additionally, it aims to identify how healthcare practitioners engaging in conversations with SMW about contraception and sexual health can improve their overall health and well-being.

Methods: A social constructionism approach informed semi-structured interviews with queer, non-heterosexual, takatāpui cisgender women, and AFAB individuals. People who identified as a non-heterosexual cisgender woman, or an AFAB individual were invited to complete a brief Google Form survey (112). This survey informed purposive sampling, where eight participants were selected to participate in a semi-structured interview. Thematic analysis was used to examine and code the semi-structured interviews, where two domains and six themes were found.

Findings: Data from the semi-structured interviews highlighted that SMW struggle to access contraceptive health care due to the barriers; disclosure of identity; assumptions of heterosexuality; lack of knowledge; and disparities in services. Furthermore, this study found that healthcare practitioners seldom initiate conversations regarding contraception and sexual health after establishing no risk of pregnancy. Despite all of these challenges, this research found that educating SMW on contraception and sexual health improves their health outcomes by providing them with the necessary knowledge to make informed decisions. Additionally, providing training and education for healthcare providers regarding queer identities and queer health works to alleviate the disparities SMW face in healthcare. Furthermore, this study found that forming a client-clinician relationship works to improve the health outcomes of SMW by providing a safe environment to disclose their sexual identity, to ask questions regarding their health, and consequently, receive the appropriate care.

Conclusions: Discussions between healthcare practitioners and SMW and AFAB individuals regarding contraceptive healthcare are an important aspect in improving the health of SMW. Providing healthcare providers with training regarding queer identities and queer health is essential in improving the health experiences of SMW and AFAB individuals, and in improving their utilisation of services. Building strong client-clinician relationships allows SMW and AFAB individuals to comfortably disclose their sexual identity, gain and share knowledge regarding their health, and access necessary services.