title: Examining clinicians' experiences providing sexual health services for LGBTQ youth: considering social and structural determinants of health in clinical practice.
abstract: Although barriers related to lesbian, gay, bisexual, transgender and queer (LGBTQ) youth's experiences accessing sexual health services have been examined in detail, research into the experiences and perceptions of clinicians providing these services has been conspicuously absent. The aim of this article is to explore the perceptions and experiences of clinicians providing sexual health services for LGBTQ youth. Drawing on in-depth, semi-structured interviews, this study examines 24 clinicians' experiences providing sexual health services to LGBTQ youth in five communities in British Columbia, Canada. Our findings reveal how many clinicians provide services to LGBTQ youth with a lack of cultural competency-either implicitly (e.g., by describing heteronormative practices) or explicitly (e.g., by expressing frustration that they had not been sufficiently provided with appropriate training related to LGBTQ youth sexual health). Institutional norms and values were identified as the dominant barriers in the effective provision of LGBTQ-tailored services. Many clinicians find themselves unprepared to provide culturally competent sexual health services that have both the capacity to address individual-level issues (e.g. promoting condom use) while considering (and adapting services to) the broader socio-cultural and structural conditions that can render LGBTQ youth socially vulnerable.
authors.affiliation: Interdisciplinary Studies Graduate Program, University of British Columbia, Vancouver, BC, Canada V6T 1Z3 and School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, Canada V6T 1Z3 rod.knight@ubc.ca.
authors.forename: R E
authors.initials: RE
authors.lastname: Knight
authors.affiliation: Interdisciplinary Studies Graduate Program, University of British Columbia, Vancouver, BC, Canada V6T 1Z3 and School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, Canada V6T 1Z3.
authors.forename: J A
authors.initials: JA
authors.lastname: Shoveller
authors.affiliation: Interdisciplinary Studies Graduate Program, University of British Columbia, Vancouver, BC, Canada V6T 1Z3 and School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, Canada V6T 1Z3.
authors.forename: A M
authors.initials: AM
authors.lastname: Carson
authors.affiliation: Interdisciplinary Studies Graduate Program, University of British Columbia, Vancouver, BC, Canada V6T 1Z3 and School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, Canada V6T 1Z3.
authors.forename: J G
authors.initials: JG
authors.lastname: Contreras-Whitney
mesh_terms: D000293:Adolescent; D001955:British Columbia; D054521:Cultural Competency; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D010817:Physician-Patient Relations; D034121:Reproductive Health Services; D012725:Sexual Behavior; D019529:Sexuality / Q000523:psychology*; D064890:Social Determinants of Health; D063106:Transgender Persons / Q000523:psychology*; D035862:Vulnerable Populations / Q000523:psychology; D055815:Young Adult