Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article

Degree

Doctor of Philosophy

Program

Nursing

Supervisor

Ford-Gilboe, M

Abstract

Physical aspects of sexual health are privileged over social, emotional, and relational considerations. This narrow focus creates barriers in operationalizing a comprehensive approach to sexual health care. This limitation is particularly evident in young women's sexual health, where the intersection of their age with biological and social factors necessitates a nuanced understanding and approach. However, progress related to women's sexuality remains hindered by systemic and gender-based inequalities that marginalize women. Advancing relevant understandings of sexual health among young women is essential, given the implications that a limited conceptualization has for nursing and healthcare in general, and ultimately young women’s health. In this study for my doctoral thesis, I explored aspects of young women’s sexual health using feminist, participatory methodology.

Throughout three interconnected manuscripts, the findings explore how young women’s identities and experiences are continually shaped by social dynamics, power relations, and intersecting identities such as race, gender, and class, and how sexual health is fluid, contextually influenced, and multifaceted nature. The first manuscript explores the complex interplay between versions of the self (social, relationships, and internal) and how these selves negotiate sexual well-being. Chapter three focuses on young women’s perspectives on safer sex, emphasizing the importance of emotional and psychological safety alongside physical protection, and identifying barriers such as inadequate sex education and societal gender norms. The final manuscript extends this understanding by examining young women’s real-life sexual experiences, highlighting their strategies for navigating safety, boundaries, and pleasure amid social inequalities. The findings underscore the need for inclusive, relational, and experiential approaches to multidimensional safe sex education and support. Collectively, these manuscripts challenge biomedical, risk-centric narratives, advocating for a holistic, agency-affirming model of sexual health and well-being that recognizes young women’s resilience and diverse realities, and calls for systemic changes to promote equity, empowerment, and well-being.

Summary for Lay Audience

This research focuses on understanding young women's sexual health in a more complete and meaningful way from a young women-centred perspective. Often, discussions about sexuality focus on biological aspects, like preventing pregnancy, while overlooking the social and emotional factors that are equally important. This narrow view can create barriers to providing better support and care for young women.

The findings from my PhD study are presented in three interconnected manuscripts that explore the concepts of sexual well-being and safer sex from the perspectives of young women. These manuscripts suggest that young women’s experiences with sexuality are shaped by many social and relational influences, as well as their intersecting identities, such as race, gender, and social class. Their understanding of sexual health is flexible and influenced by their environment. The research highlights the importance of emotional safety, good communication, and respect in sexual relationships, and points out the gaps in sex education and societal norms that can make young women feel unsafe or judged.

Overall, the findings challenge traditional, risk-focused ideas about physical sexual health and promote a more holistic approach that recognizes young women’s resilience and diversity. The goal is to begin to develop a knowledge base that can inform policies and practices that promote better support for young women’s sexual and reproductive well-being, ultimately contributing to social change and greater fairness in health care and education systems.

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