Examining LGBTI+ inclusive sexual health education from the perspective of both youth and facilitators: a systematic review

OBJECTIVES: To critically appraise and synthesise the evidence in relation to both the receipt and delivery of LGBTI+ (Lesbian, Gay, Bisexual, Transgender, Intersex) inclusive sexual health education. DESIGN: A systematic review and narrative synthesis. DATA SOURCES: A systematic search of three online databases (EMBASE, PsychINFO and SocINDEX) from January 1990 to May 2021 was conducted. ELIGIBILITY CRITERIA: Studies included were (1) peer-reviewed; (2) English; (3) quantitative, qualitative and mixed methods; that evaluated (4) inclusive sexual health in an educational or online setting and (5) focused on training or educating. Studies were excluded if (1) the population was not LGBTI+ inclusive; (2) the studies did not focus on original data or (3) the study was not available in full text. DATA EXTRACTION AND SYNTHESIS: The studies that met the inclusion criteria were assessed using the Critical Appraisal Skills Programme tool. A narrative synthesis was then completed employing content analysis focusing on the results section of each article. RESULTS: Of the 5656 records retrieved, 24 studies met the inclusion criteria. The majority of studies noted that both LGBTI+ youth and those who facilitate sexual health education are turning to online sources of information. Current sexual health education programmes operate mainly from a heterosexual perspective, creating a sense of exclusion for LGBTI+ youth. This is compounded by a lack of training, or provision of an inclusive curricula, resulting in facilitators feeling ill equipped or inhibited by their personal biases. CONCLUSIONS: LGBTI+ youth are not experiencing inclusive and comprehensive sexual health education. In parallel, educators report poor access to information, training and resources remain the primary reasons. There is a need to standardise sexual health curricula, making them LGBTI+ inclusive and incorporate holistic aspects of health such as pleasure and healthy relationships. Online approaches should be considered in the future, as they represent equality of access for both sexual health education professionals and LGBTI+ youth alike.