Survey finds that Toronto teens need more sexual health education and clinics

Teens in Toronto are engaging in risky sexual behaviours, a report released today shows, and young people in the groups most at risk are not getting the information they need to protect themselves.

The Toronto Teen Survey found that sexual health education and services need to be improved in Toronto, where rates of HIV and other sexually transmitted infections are increasing.

“Toronto teens are sexually active in a wide variety of ways but 83 per cent have never accessed sexual health care from a doctor or a clinic,” says Susan Flynn, director of research and program development for Planned Parenthood Toronto. “Most still fear that they will be judged, and they are very concerned about confidentiality. And those who have accessed sexual health care services are unhappy with that care.”

The survey of 1,216 teens, ages 13 to 18, is believed to be the largest and most diverse sample of Toronto teens ever done for the purposes of studying youth sexual health needs. It is a joint project of Planned Parenthood Toronto, York University, the University of Toronto and Wilfrid Laurier University, in collaboration with Toronto Public Health.

The survey concludes that teens experience a variety of barriers to sexual health information and services; the type and impact of the barriers varies greatly, depending on the teen’s age, gender, language, race and ethnicity, sexual orientation, immigrant/refugee status and socio-economic status.

“Teens need both sexual healthcare services and education that are tailored to their age and situation,” says Sarah Flicker (right), professor of environmental studies at York University. “The information and services that work for a 14-year-old Asian lesbian are not going to be the same as what works for an 18-year-old straight African male who is a newcomer to Canada.”

Sexual practices were rated from no risk (inexperience or masturbation) to high risk (vaginal and anal intercourse). The survey found that young women were twice as likely to access sexual health services, but that males, younger survey respondents and people from the black, Asian, Aboriginal and Muslim communities were less likely to use sexual health services.  

Eight percent of the Toronto teenagers who took part in the survey had not had any sex education at all. In many cases, these were older teens who had immigrated to Canada recently, missing mandatory sex education in elementary and early high school grades.

Even those who had received sex education said it didn’t teach them what they want to learn. The top three sexual health topics youth have learned about are HIV/AIDS, sexually transmitted infections, and pregnancy and birth control. The top three topics they want to learn about are healthy relationships, HIV/AIDS (more information) and sexual pleasure.

The report calls for a number of major changes to be implemented by the Ministry of Health, doctors and clinics, Toronto Public Health, community organizations, and the Ministry of Education, school boards and schools. For example, it recommends:

  • health services aimed at youth in under-served neighbourhoods;
  • clinic staff who represent the diverse youth communities they serve (gender, sexual diversity, race and religion etc.);
  • age-appropriate sex education each year from kindergarten to Grade 12;
  • sexual health curriculum for diverse youth populations, addressing issues of sexism; racism, homophobia, transphobia etc.;
  • mobile clinics or other strategies to bring services to youths;
  • community organizations and clinics that are youth-friendly and sex-positive;
  • and, a youth bill of sexual health care rights. 

The full report and list of recommendations are available here.

The Toronto Teen Survey project involved teens in all aspects of the survey: members of a youth advisory committee helped write the questions appropriate for their peers, were trained in sexual health care education, and conducted 90 workshops in which they were careful to ensure the confidentiality of both survey responses and questions submitted during question-and-answer sessions. The workshops were held at after-school programs, shelters, summer camps, community centres, group homes and other gathering places. Focus groups were held with 80 service providers such as social workers, public health practitioners and community outreach workers.

June Larkin, vice-principal of New College at the University of Toronto, and Robb Travers, psychology professor at Wilfrid Laurier University, were co-investigators on the project, with York Professor Sarah Flicker and others, who were assisted by more than 15 graduate and undergraduate students from the three universities. The survey was funded largely by the Ontario HIV Treatment Network and the Canadian Institutes of Health Research (CIHR).

The Toronto Teen Survey project was awarded the CIHR Synapse Youth Mentorship Award, which recognizes the efforts of a graduate student or postdoctoral fellow who has made exceptional efforts to promote health research among Canada’s high school students.