Healthy sexuality development in adolescence: proposing a competency-based framework to inform programmes and research

Abstract

Positive aspects of sexuality remain understudied among young people globally, and consensus is lacking on how to conceptualise different aspects of healthy adolescent sexuality development in order to guide programmes, research, and policy. We propose a conceptual framework that draws on theories and literature related to positive youth development, empowerment, human rights, gender, social-ecological and life-course perspectives. The framework highlights six key competencies for healthy adolescent sexuality development: (1) sexual literacy, (2) gender-equal attitudes, (3) respect for human rights and understanding consent, (4) critical reflection skills, (5) coping skills, and (6) interpersonal skills. These competencies have the potential to strengthen or impede adolescents’ sense of sexual wellbeing in relation to both themselves (e.g. body image, self-efficacy) and others (e.g. mutually respectful relationships). Whether adolescents are able to translate competencies into desired actions and achieve a sense of sexual wellbeing depends on the resources available to them, their agency, and on the influence of social-ecological opportunity structures. The framework can provide concrete direction for sexual and reproductive health practitioners and researchers by providing a platform for recognising and operationalising indicators of healthy sexuality development, and serve as a Theory of Change for programmes aiming to improve adolescent sexual and reproductive health and wellbeing. Our assets-based, life-course approach can also be used to make the case to donors and policymakers for why early investments and positive approaches to adolescent sexuality are needed to achieve sexual wellbeing over time.

Young Adults’ Understanding of Sexual Competence: A Qualitative Study with German University Students

“…First, it can be assumed that the most frequent themes mentioned by the participants (i.e., awareness and actualization of needs/desires, communication, skills/abilities, setting boundaries/limits, treatment of the partner/oneself, knowledge) present the core components of young adults' understanding of sexual competence, reflecting their motivation to gain more competence in these components. This corresponds with a recent framework for youth sexual well-being that recommends promoting a positive approach to sexuality and moving beyond prevention programs addressing predominantly condom use and STIs (Kågesten & van Reeuwijk, 2021). While some recent intervention programs focused on teaching life skills, for example (sexual) assertiveness (Lee & Da Lee, 2019;Widman et al, 2017), they predominantly addressed safer sex practices, such as condom use.…”

Exploring school girls' menstruation characteristics and impacts on their academic performance

“…Given the possibility of gender dysphoria during adolescence and the dread of menstrual leaks being observed by others, trans and non-binary people who menstruate may be especially susceptible to stigma [ 19 ]. Although many adolescents in wealthy nations have limited knowledge of menstruation and are unprepared for menarche, adolescents in low-income groups have even less information and are even less prepared [ 20 ].…”

Reproductive agency and the value of reproductive choice among migrants from the Middle East and North Africa and Sub-Saharan Africa living in Sweden–a cross-sectional analysis of the Migrants World Values Survey

“…Migrants, including asylum seekers and refugees, often experience SRHR inequalities both at the healthcare system and the patient-provider levels. Disparities also exist in migrants' health-seeking behavior and the perceived cultural and social freedom to make one's own choices [12][13][14]. This may be due to social and nancial vulnerabilities, restricted access to healthcare because of language barriers, and lack of knowledge of how to navigate the healthcare system.…”