Voluntary childlessness remains a socially contested life choice in pronatalist contexts where womanhood is strongly associated with motherhood. This study examines how voluntarily childless women in Türkiye experience social expectations, normative judgements, and emotionally framed persuasion within the broader framework of gender regimes. Drawing on secondary qualitative data, the study analyses in-depth interviews with 18 voluntarily childless women living in İstanbul and Ankara. Data were examined through thematic analysis. The findings show that participants' experiences are shaped by three interconnected dynamics: temporal pressure organised around a socially constructed reproductive timeline; normative evaluations that equate femininity with motherhood; and emotionally framed persuasion practices that encourage childless women to reconsider their decision. Participants reported that remaining childfree was often interpreted as incompleteness, deviation, or delayed normality, requiring them to justify their reproductive choices in everyday interactions. These pressures rarely appeared as direct coercion; rather, they operated through subtle warnings, moral evaluations, and narratives of regret, loneliness, and fulfilment. The study highlights how reproductive decisions are socially regulated within pronatalist gender regimes in contemporary Türkiye.
What processes are set in motion when someone discovers they are pregnant unintentionally, and what is the role of culture in these processes? This question is explored through narratives of women in the Philippines and Kenya on their first pregnancy carried to term. We show how an unintended pregnancy provides a window onto making kin and delineating the implied responsibilities towards the future child and its mother. As participants accounts demonstrate, in both Kenya and the Philippines an unintended pregnancy can be conceptualised as a period of pressured and risky social gestation. Pressured, because although the process of social gestation may continue after birth, the fact of a due date means arrangements around birth, living spaces and care must be concretised in time. And risky, because the claim to kinship and thus support might be denied. Diversity of patterns in social gestation between the two contexts, and within the Kenyan context, suggests that they are shaped by specific 'cultures of relatedness. Future research should incorporate perspectives from others involved in the social gestation process, such as the parents of the intimate partners, to explore how cultures of relatedness shape the making of kin and gendered inequalities following an unintended pregnancy.
This interview study examined how postpartum women socialised within the Purity Culture Movement (PCM) in the USA navigated inherited sexual scripts during the transition to motherhood. Purity Culture, a religious system emphasising premarital abstinence, modesty, and sexual obligation within marriage, is widely associated with sexual shame and relational strain. Less is known about how women rework these beliefs after childbirth. Fifteen postpartum women were recruited from faith-informed maternal communities across the USA and screened to include those reporting either high or low sexual satisfaction. Interviews were analysed using reflexive thematic analysis within an interpretive feminist framework. Four processes were identified through which purity-based meanings were destabilised, renegotiated, or intensified. Bodily change, sexual pain, marital communication, and faith-based reinterpretation were key sites of negotiation. Women described moral responsibility, distance from their own desire and silence about sexual health, alongside embodied reclamation, shared rewriting of sexual scripts and greater flexibility in belief. Relational safety, access to clinical language and care, and theological flexibility distinguished renegotiation from intensification. Postpartum emerged as a bifurcated life-stage in which inherited religious sexual scripts may be reinforced or remade, with implications for culturally responsive sexual healthcare and for scholarship on religion and sexuality.
This study examines the sociocultural dimensions of period poverty and their relationship to sustainable menstrual hygiene management (MHM) through a qualitative case study of rural communities in Fiji. Fieldwork was conducted in four remote Fijian communities using talanoa methodology. The findings indicate that sociocultural stigma surrounding menstruation persists, although its intensity varies depending on community size and generational attitudes. The provision of free reusable pads encourages greater dialogue about menstruation between men and women and thereby contributed to reducing menstrual taboos within families and communities. However, limited water access, inadequate sanitation infrastructure, and enduring sociocultural stigma continued to impede effective MHM and the sustainable use of reusable products. Environmental awareness relating to menstrual waste remains limited. Addressing period poverty in Fiji requires context-specific programmes and interventions on MHM education for both women and men, not only in the community but also in schools and workplaces, while greater attention is given to improving water and sanitation infrastructure in remote settlements and villages.
Sexual and gender minorities in the USA are disproportionately impacted by HIV, highlighting the need for tailored prevention and treatment interventions. Video-based tools have emerged as promising for disseminating HIV-related information due to their accessibility, scalability and cultural adaptability. However, there is limited research on video content and presentation style preferences, particularly among diverse sexual and gender minorities. This study explored video content and style preferences among English- and Spanish-speaking US sexual and gender minorities to inform the development of a bilingual HIV video-based educational intervention. Six focus groups (4 in English, 2 in Spanish) were conducted in Washington, DC. Thematic analysis was conducted using the Framework Method. The sample (n = 28) included 18 English- and 10 Spanish-speaking adults who ranged in age from 24 to 69 years. Participants largely identified as gay (70%) and as cisgender men (63%). Most were HIV-negative (55.5%), non-Latino/x/a (52%) and White (52%). Three overarching themes were identified: (1) simplify complex concepts, (2) align content delivery with modern media consumption norms; and (3) maximise relatability. Spanish-speaking participants recommended using widely understood Spanish to reach diverse Latino/x/a communities. Findings underscore the importance of cultural and linguistic diversity to ensure equitable health communication when developing video-based HIV educational interventions.
In the USA, Latino, Black, and other ethnically or racially minoritised sexual minority men and nonbinary individuals assigned male at birth experience a disproportionate burden of HIV and significant stigma that can impede HIV prevention. Understanding how stigma shapes sexual relationships and networking is critical for informing HIV prevention efforts. We conducted interviews with 18 ethnically or racially minoritised sexual minority men and nonbinary individuals assigned male at birth recruited through the National HIV Behavioural Surveillance Project (cycle 6) in Boston, Massachusetts (2020-2021). Eligible participants were at least 18 years old, identified as men or nonbinary (assigned male at birth), identified as persons of colour, lived in the Boston metropolitan area, and reported ever having sex with a man. Interviews were analysed using thematic analysis. Participants (mean age = 26.4 years) described race-, ethnicity-, and sexuality-related stigma, including sexual fetishisation, objectification, rejection, and exclusion by potential partners. These experiences influenced sexual networking by fostering increased scepticism, guardedness, selective partner choice, and pre-emptive disclosure of marginalised identities to reduce anticipated rejection. Themes reflected broader patterns of stigma and stigmatisation rather than HIV epidemic-specific experiences.
Despite the existence of laws protecting human rights in Rwanda, lesbian, gay, bisexual, transgender, and queer (LGBTQ+) people continue to face discrimination with its roots in cultural, religious, and moral beliefs. This study explored the lived experiences of LGBTQ+ individuals using a phenomenological design. Data were collected through in-depth interviews, focus group discussions, and digital storytelling with 57 participants from six districts. Participants were recruited through purposive and snowball sampling, ensuring homogeneity and representation. A thematic queer phenomenological analysis was performed. Guided by the socioecological model, the analysis identified five key themes revealing experiences across individual, interpersonal, community, organisational, and policy levels. Findings highlight internalised stigma, family rejection, misinformation, and discrimination in healthcare and employment. While prior studies have noted the absence of legal protections, this study revealed how legal ambiguity is lived as an embodied and multilevel experience, shaping identity expression and the everyday navigation of heteronormativity spaces. Despite challenges, community-based organisations fostered resilience and belonging. Findings highlight the need to consider the lived experiences of LGBTQ+ community members when educating society about gender and sexual orientation, as well as designing inclusive programmes and policies across these levels to protect members of this community.
This article examines puberty as a socially constructed phenomenon using data from semi-structured interviews with 45 adolescents (aged 12-16). Drawing on feminist and constructivist frameworks, the research reveals three principal mechanisms of social construction: institutional adultocentrism that normalises adolescent bodies through medical and educational surveillance; gendered differentiation of bodily experiences that reproduces inequalities; and digital mediation that generates both opportunities for emancipation and new forms of normative control. The study highlights the need for more inclusive institutional approaches to puberty that recognise adolescent agency and the plurality of pubertal trajectories, moving beyond biomedical reductionism towards a more genuinely social understanding of this stage of life.
Exposure to representative imagery, or a lack thereof, has mental and physical health impacts including limiting or expanding a person's beliefs about possibilities for themselves and those with shared identities. We previously conducted a content analysis of 182 anatomical illustrations from eight college-level human sexuality textbooks, finding only 12.6% of images represented medium skin tones and 1.1% of images represented dark skin tones. Building upon these findings, we held four focus groups with 19 college students of colour at a US university to examine students' beliefs about existing anatomical illustrations from human sexuality textbooks. We then conducted two follow-up focus groups where we shared commissioned illustrations reflecting greater diversity in skin colour, body types, and body characteristics. Data were analysed using thematic analysis. Three themes were generated from the focus groups: 1) implications of skin tone bias and white normativity; 2) harmful impacts of idealistic and unrepresentative body portrayals on self-esteem and body image; and 3) positive impacts of representative and inclusive imagery. Our findings demonstrate how unrepresentative images have adverse implications for mental wellbeing and body image, while sustaining structural injustices. Including more representative images within educational materials could positively impact self-esteem, body image, and belonging for students.
A sense of belonging, and feeling part of a group that values, supports, and accepts oneself, is a vital aspect of overall well-being and buffers against a myriad of psychological stressors. Lesbian, gay, bisexual, transgender, queer, and other sexual and/or gender marginalised (LGBTQ+) people often turn to LGBTQ+ communities to connect, feel safe, and avoid overly internalising stressors they face. Belonging in LGBTQ+ communities, while beneficial, has yet to be conceptualised specifically from LGBTQ+ people's perspectives. In this study, 404 LGBTQ+ adults, surveyed via Prolific, responded to an open-ended survey question to share the factors they believed contribute to their sense of belonging in LGBTQ+ communities. Using thematic analysis, the following six themes were developed: mutuality; accepting environments; identity and authenticity; having existing relationships in LGBTQ+ communities; active engagement; and LGBTQ+ representation. Findings provide nuance to existing conceptualisations of belonging and offer mental health practitioners identify potential areas to explore so as to help LGBTQ+ people develop a sense of belonging. Implications for research and advocacy are discussed.
This article examines the links between cultural meanings of intimacy and notions of family in the post-socialist setting of Bulgaria. Bulgaria is a country with highly gendered, heteronormative and conservative social norms about family and coupledom. Using a bricolage perspective, this research aimed to provide insight into the way these norms are integrated, reworked and possibly challenged in the narratives of intimacy of urban heterosexual young people. Data were collected from semi-structured interviews with 48 young people (16-25 years old) living in cities. The results show that their perceptions of intimacy reflect culturally important meanings and practices of family life, coupledom and selfhood. Three types of intimacy were identified - familistic, hybrid and individualistic. These models shaped participants' expectations and notions of love, relationships and intimacy and the way the actual experience in intimacy is viewed and interpreted.
Hispanic men have vasectomies at markedly lower rates than non-Hispanic White men in the USA, even though vasectomy is safer, more effective, and less expensive than female sterilisation. Conceptualising vasectomy beyond a biomedical intervention, the article positions vasectomy as a site of political contestation where masculinity, sexual expertise, fertility accountability, access to care, and memories of sterilisation abuse intersect. The results run counter to traditional explanations based solely on machismo. Instead, factors including low awareness, sexual dysfunction myths, Spanish-language counselling barriers, lack of insurance coverage for male contraception, female-focused family planning, provider bias, and medical mistrust from sterilisation abuse against Latina and Mexican-origin women help explain the Hispanic-White vasectomy disparity. Recent increases in vasectomy requests following the US Supreme Court ruling on Dobbs v. Jackson Women's Health Organisation, which ended federal constitutional protection for abortion and returned its regulation to individual states, suggest that men will access permanent contraception when reproductive circumstances change. However, inequities may continue to limit Hispanic men's access and use unless sexual and reproductive health policy is culturally grounded, gender-balanced, linguistically accessible and responsive to the history of coercive sterilisation in the USA.
This article examines how mental health practitioners in Aotearoa New Zealand understand the ways historical trauma, particularly child sexual abuse (CSA), surfaces in their work with young Sāmoan women who present with depression. Drawing on talanoa with 16 mental health practitioners supporting Sāmoan women aged 18-24, the study identifies a consistent pattern: depression often masks long-silenced experiences of CSA. Disclosures typically emerge after several years of silence, shaped by cultural and familial norms that restrict conversations about sexual harm within Sāmoan communities. Practitioners described recognising trauma through relational and culturally attuned engagement rather than direct disclosure. Their accounts echo international evidence on delayed CSA disclosure among minoritised populations, while highlighting the cultural factors shaping help-seeking for Sāmoan women. By centring practitioners' interpretations, the study underscores the need for trauma-informed, culturally grounded mental health responses that acknowledge both shared and culturally specific dimensions of silence, disclosure and healing. Strengthening practitioners' capacity to recognise and respond to hidden trauma is critical for supporting young Sāmoan women whose experiences often remain unrecognised within mental health systems. The findings also emphasise the importance of locally grounded approaches, recognising that while patterns may echo across Pacific communities, pathways to healing must remain culturally specific.
Chronic stress is a driver of increased risk for disease and mental health challenges, which disproportionately affect Latine individuals assigned male at birth (AMAB). Latines are one of the fastest growing sub-populations in USA warranting urgent action to remediate inequities. Because of this, a better understanding of stress and coping pathways is needed to improve targeted programmes and interventions. Semi-structured interviews were conducted with 30 queer AMAB Latine participants aged 18 to 68 in the continental USA, representing diverse socioeconomic and life experiences. Thematic analyses explored perspectives on health, gender, masculinity, stressors, and coping strategies. Participants defined health holistically and described chronic stress as shaped by structural factors, including the sociopolitical climate, institutional barriers, family obligations, and rigid gender expectations. Participants also described actively renegotiating masculinity and drawing on cultural pride, community, and collective care as sources of resilience, wellbeing, and joy. Findings underscore the need for approaches that address systemic inequities while also attending to the existing assets queer AMAB Latine individuals draw upon in order to survive and thrive. Study findings invite a shift from deficit-based models towards frameworks that highlight cultural strengths, relational care, joy, and locally grounded practices of coping and wellbeing.
In Malaysia, pervasive institutional discrimination harms lesbian, gay, bisexual, transgender and queer (LGBTQ+) people and complicates how they may build and sustain trust with different public institutions. Employing a mixed-methods approach, this study examined the prevalence of institutional (dis)trust among a sample (n = 647) of LGBTQ+ adults in Malaysia, and the factors that influenced their institutional (dis)trust. Using descriptive analyses and generalised linear regression to explore demographic differences in the prevalence of institutional (dis)trust across police, political, law, and media institutions, we found that cisgender women, trans men, and non-binary participants (compared to cisgender men), as well as Malay and Indian participants (compared to Chinese), reported higher distrust towards different public institutions. Participants' open-ended responses (n = 228) were analysed using reflexive thematic analysis to identify three interrelated themes that described the factors influencing LGBTQ+ people's institutional (dis)trust: 1) being the target of scapegoating, 2) fear of dehumanisation, and 3) waning hope for the future. The findings highlight the need to strategically address institutional discrimination towards LGBTQ+ people in Malaysia, as a means for bolstering their institutional trust and improving their long-term health and well-being.
Inspired by decolonial theorist Sabelo Ndlovu-Gatsheni's notion of 'reworlding' and his use of the concept to reconsider Western epistemes and ways of 'being in the world', we argue for the importance of 're-worlding reproduction' in future work on health systems and reproductive health. Current approaches to reproductive health have failed to bring the thriving and wellbeing they once promised to the 'marginalised majority' in the world. Re-worlding reproductive health requires: 1) the decolonisation and Indigenisation of reproductive rights; 2) an ongoing process to contest coloniality and reverse its ongoing effects; 3) the right to define our own realities; and 4) imagining into action a world fit for our descendants. Future knowledge-making in relation to reproductive health should draw upon diverse epistemes and inclusive research methods, and address disparities in academic publishing. People seeking care within reproductive health settings often experience racism and structural violence, compounded by poverty, illiteracy, patriarchy, heterosexism and global economic stratification. Reproduction gives rise to future generations for whose survival we need to address environmental pollution and climate change as integral to a thriving future.
This study investigated abortion providers' experiences during Norway's recent regulatory transition extending the time allowed for self-determined abortion from 12 to 18 weeks. Through semi-structured interviews with 12 healthcare professionals, we captured abortion care providers' views on their work and expectations about the regulatory shift. Despite finding abortion care meaningful and supporting patients' autonomy, providers expressed significant anxiety about the reform, revealing a paradox in which supportive providers feared the effects of a liberalising policy. This anxiety stemmed from practical concerns about capacity associated with challenges in managing pain, complications, and emotional intensity in terminations after 12 weeks rather than moral objections. Healthcare workers felt responsible for adapting to new regulations without being informed about the practical implications for their work. Our findings suggest that gestational age may shape providers' emotional and possibly moral experience of abortion work in ways that are difficult to articulate within progressive contexts. This study demonstrates that expanding abortion access requires more than legislative change. Attention to abortion care providers' working conditions and expectations is crucial for translating progressive policies into good abortion care.
Masculinities influence sexual, reproductive, and mental health outcomes and health seeking behaviours, as they intersect with socioeconomic, cultural and political forces. In post-apartheid South Africa, racialised inequities and social change shape how young men navigate gender and relationships. This paper explores how young men living in urban informal settlements understand masculinity and relationship power. Cognitive interviews were conducted with 17 men aged 21-30 from Durban and Soweto, reflecting on their sexual relationships while responding to a 13-item Sexual Relationship Power (SRP) scale. Thematic analysis was undertaken. Findings revealed three interconnected themes on participants' perceptions and enactments of masculinity: (1) tradition versus transition, where cultural identity and evolving gender norms influence domestic labour and relationship roles; (2) control as care, highlighting how surveillance of women's mobility and appearance, and possessiveness were framed as protection; and (3) masculinity and the power to decide, where decision-making was negotiated through culturally informed expectations of male authority, emotional insecurity and shifting relationship power dynamics. Participants' masculinities ranged from traditional to egalitarian, demonstrating how masculinity is contextually and relationally performed. Findings underscore the need for contextually grounded, gender transformative programmes and interventions that address masculinity as multiple, dynamic and relational rather than as a static identity.
HIV prevention among young people in sub-Saharan Africa is often understood as an individual response to epidemiological risk, yet in many East African contexts prevention is negotiated within relationships shaped by trust, morality, and social recognition. Drawing on data from a mixed-methods study conducted with 460 young people and 24 key informants in Tanzania's Southern Highlands, this study examines how relational commitment reshapes the meanings of HIV testing and condom use. Quantitative findings show that 68.2% of respondents reported HIV testing in the past 12 months, and testing increased with higher levels of relational commitment, whereas consistent condom use, reported by 47.5%, did not follow the same pattern. Qualitative narratives reveal a clear moral distinction: testing in committed relationships is framed as a collaborative act of care and reassurance that affirms trust, while condom negotiation is often interpreted as signalling suspicion or possible infidelity. These findings show that HIV prevention operates within relational moralities that differentiate forms of protection and highlight the need to approach prevention as a cultural and communicative process. Study findings thereby extend sexuality scholarship on intimacy, risk, and prevention in Tanzania.
This study analyses how LGBTQ+ healthcare users and healthcare professionals navigate and reconfigure access to healthcare within Brazil's Sistema Único de Saúde (Unified Health System) in contexts shaped by institutional LGBTQ-phobia. The study employed a qualitative intervention-research design informed by cartography. Fieldwork was conducted in a family health clinic in northeastern Brazil and combined participant observation with semi-structured interviews with LGBTQ+ healthcare users and healthcare professionals. The analysis conceptualises access not as a linear process but as a set of negotiated pathways, mapped as five routes of access to healthcare: facilitated access; access 'by force'; unnoticed access; access through detours; and access through support networks. These routes reveal how access is continuously produced through relational practices, micropolitical negotiations and collective arrangements that both reproduce and disrupt institutional norms. The findings position agency as a central analytical axis, demonstrating how subjects and professionals actively invent alternative forms of care in response to institutional violence and exclusion.
