Developing an Inclusive Model of Young Heterosexual and Sexual Minority Women’s Sexual Decision-Making

ABSTRACT

Efforts to improve sexual health outcomes among young cisgender women require in-depth understanding of how women with diverse sexual identities make decisions about their sexual health. We conducted semi-structured interviews with 31 young cisgender women with diverse sexual identities and histories (age range 18–29 (M = 23.32); 81% White; 29% bisexual, 26% heterosexual, 16% lesbian, 13% queer, 10% pansexual, 3% gay, 3% demisexual) about their decision-making surrounding sexual risk reduction. By conducting thematic analysis, we found that, regardless of partner sex or gender, women adapted sexual health strategies based on how much commitment, trust, and communication existed in their relationships. Because heteronormative structural influences limited access to information and safer sex options, women had to rely on trust and communication more with other women and partners with vaginas, compared to men and partners with penises. Women did not consider safer sex strategies with partners with vaginas (e.g. hand washing) risk-reduction techniques; instead, they considered them general hygiene or a way to take care of a partner. We propose that an inclusive model of young women’s sexual decision-making should: (a) highlight the influence of relationships; (b) frame prevention in terms of overall health instead of pregnancy and STIs; and (c) acknowledge that structural factors, such as heteronormativity and sex-negativity, constrain women’s decisions.

Acknowledgments

The authors extend their gratitude to Dr. Caroline Sanner, who provided feedback on a draft of the manuscript and whose expertise was essential to shaping the methods section.

Disclosure Statement

No potential conflict of interest was reported by the authors.

Supplemental data

Supplemental data for this article can be accessed online at https://doi.org/10.1080/00224499.2024.2320260

Notes

¹ We have edited quotes by removing words such as “like” and “you know” when we believed they interfered with the readability of the quote. All participants are represented with pseudonyms.

Additional information

Funding

This work was supported by the Virginia Tech Institute for Society, Culture, and Environment.