ArticleContraception2025
Beyond stigma: Clinician bias in contraceptive counseling to sexual and gender minority youth.
Article in Contraception, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- "I liked having my voice heard:" a feasible, rapid approach for codesigning a contraceptive counseling curriculum.Academic medicine : journal of the Association of American Medical Colleges · 2026Article
- Men's involvement in contraception: a qualitative study exploring the perceptions and practices of general practitioners in France.Preventive medicine reports · 2026Article
- Associations between sexual and black and white racial identity and most used contraceptive method in young women: Results from the Pittsburgh girls study.Contraception and reproductive medicine · 2026Article
- A qualitative study on healthcare providers' biases towards transgender and gender diverse people accessing contraceptive care.Sexual and reproductive health matters · 2025Article
- Trust, autonomy, and informed consent: a qualitative investigation of youth experiences accessing contraception in Canada.Sexual and reproductive health matters · 2025Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
objectivesSexual and gender minority (SGM) youth experience disparities in sexual and reproductive health; however, little is known about how clinicians engage in contraceptive counseling with this patient population. This study describes pediatric clinician patterns and biases in contraceptive counseling with SGM youth. STUDY
designWe conducted 16 in-depth interviews with a convenience sample of clinicians who counsel adolescents on contraception. Participants were recruited and interviewed in-person at the American Academy of Pediatrics National Conference in October 2022. We used codebook thematic analysis.
resultsWhen discussing contraceptive counseling among SGM youth, three major themes emerged: (1) participants' acceptance of SGM youth identities varied from support to suspicion and rejection; (2) participants' conceptualizations of their SGM youth patients' identities circumscribed the scope of the contraceptive care they provided; and (3) participants described using a universal approach to contraceptive counseling that disregarded the relevance of SGM youth identities. For transgender patients, many clinicians focused on menstrual regulation and overlooked potential pregnancy risk. When discussing sexual minority patients, clinicians overemphasized pregnancy prevention and encouraged the use of highly effective contraceptive methods rather than taking a shared decision-making approach to contraceptive care.
conclusionsMany clinicians demonstrated bias in approaches to contraceptive care provision to SGM youth patients by holding patients accountable to normative assumptions in transgender medicine and family planning. Training and support for adolescent-facing clinicians in bias recognition and comprehensive contraceptive care are necessary to provide person-centered reproductive health care to SGM youth. IMPLICATIONS: This qualitative study of pediatric clinicians' self-reported contraceptive care delivery revealed limited acceptance of sexual and gender minority youth identities and biased assumptions about which patients may need or desire specific contraceptive methods. Such practices overlook clinically-relevant differences among pediatric patients.
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