Perspectives on Sexual and Reproductive Health最新文献

{"title":"How Are Healthcare Providers Conscientiously Objecting to Abortion in Australia? A Qualitative Study.","authors":"Bronwen Merner, Casey M Haining, Lindy Willmott, Julian Savulescu, Louise A Keogh","doi":"10.1111/psrh.70058","DOIUrl":"10.1111/psrh.70058","url":null,"abstract":"<p><strong>Introduction: </strong>Researchers have done limited empirical work to explore how healthcare providers are claiming conscientious objection to abortion care in Australia. Without this research, we cannot assess if existing mechanisms to regulate conscientious objection meet the needs of abortion seekers, abortion providers, and healthcare providers who conscientiously object to abortion care.</p><p><strong>Methodology: </strong>We conducted semi-structured interviews with 41 interest-holders (including healthcare providers who provided or conscientiously objected to abortion care) across Australia about conscientious objection to abortion care and its regulation. We analyzed the data using framework analysis.</p><p><strong>Results: </strong>We identified four themes describing how healthcare providers were claiming conscientious objection to abortion care. First, claims existed on a spectrum from \"partial provision\" to \"refusal without referral.\" When healthcare providers refused to provide an abortion, they did not always refer the abortion seeker to a willing provider or service. Second, claims of conscientious objection could change over time. Third, the relationship between religion and conscientious objection was not necessarily direct. Finally, some healthcare providers refused to provide abortion for reasons other than conscience.</p><p><strong>Conclusion: </strong>The findings demonstrated that conscientious objection provisions provided a flexible mechanism for healthcare providers to opt-out of providing abortion care at different times, in different contexts, and for different reasons (including reasons other than conscience). Education and guidelines may improve healthcare providers' understandings and interpretations of conscientious objection provisions. Destigmatizing interventions may also reduce the number of healthcare providers who refuse to participate in abortion care for conscience-based and non-conscience-based reasons.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":"58-68"},"PeriodicalIF":3.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12976807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146167329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the One-Child Policy on Reproductive Decision-Making Among People of Chinese Descent in the United States: An Exploratory Study.","authors":"June Hoi Ka Ng, Jessica Atrio, Nadia Nguyen, Nerys Benfield","doi":"10.1111/psrh.70047","DOIUrl":"10.1111/psrh.70047","url":null,"abstract":"<p><strong>Introduction: </strong>China's one-child policy was implemented in 1980 primarily through mandatory intrauterine devices, tubal surgery, or abortion for \"unauthorized pregnancies.\" While it was replaced in 2015, it affected millions of persons and its effects on reproductive decision making are not well known.</p><p><strong>Methods: </strong>We designed, validated, and performed a cross-sectional survey of reproductive age Chinese-born or first-generation women of Chinese descent to describe the policy's impact on reproductive decision-making. Descriptive statistics and multivariate logistic regression were used to identify self-reported policy impact on contraceptive utilization and childbearing choices, and demographic associations.</p><p><strong>Results: </strong>Between June 1 and October 31, 2021, 1098 people accessed the survey, and 838 were eligible. A total of 588 responded to questions pertaining to the primary outcome, yielding a response rate of 70.2%. Approximately 42% of participants lived under the policy and were affected by it in some way. 17.3% of participants stated their contraceptive utilization was affected and 23.3% stated their childbearing choices were affected. Those with low acculturation scores (OR = 2.27, 95% CI 1.35-3.85, p = 0.002) and those living in the United States for < 21 years (OR = 2.25, 95% CI 1.09-4.67, p < 0.01) were more likely to report their contraceptive plans were affected. 72.8% of participants self-reported high reproductive autonomy, whereas acculturation was mixed.</p><p><strong>Conclusions: </strong>Although the one-child policy has had a large effect on people of the Chinese diaspora, its impact on reproductive decision-making may decrease with the duration of time in the United States and increasing acculturation.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":"16-29"},"PeriodicalIF":3.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145716110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Young Transgender and Gender Nonconforming Persons Seeking Endocrine Care in the University Hospital Nancy: Lessons Learned and Challenges.","authors":"Eva Feigerlova","doi":"10.1111/psrh.70048","DOIUrl":"10.1111/psrh.70048","url":null,"abstract":"<p><strong>Introduction: </strong>Over the last decade at the University Hospital of Nancy in Lorraine, France, we have observed an increasing number of people under 35 years old who receive consultation for gender incongruence, from an average of 7 new patients per year in 2002-2013 to an average of 27 per year in 2014-2017.</p><p><strong>Methods: </strong>We conducted a mixed-methods study, including a retrospective quantitative analysis of medical records of youths who sought care for gender incongruence from 2004 to 2020, and a qualitative analysis of in-depth interviews with 11 patients identified through the medical records.</p><p><strong>Results: </strong>The study included 235 participants (135 assigned female at birth, 100 assigned male at birth). Transgender men were younger than transgender women: mean age 20 (1.6, standard deviation, [SD]) years vs. 22.7 (4.3 SD) years; p = 0.01 at first referral. We observed no difference in age at the initiation of gender-affirming hormonal treatments. More than half of our participants chronologically situated their first questioning about their gender identity in the prepubertal period. Their life experiences revealed a lack of transgender representation in society, discomfort with the treatments offered, difficulties in becoming aware of and disclosing their gender identity, and the importance of peer/community support.</p><p><strong>Conclusion: </strong>The present study provides insights into the growing population of transgender and gender nonconforming people receiving care in the University Hospital of Nancy which has coincided with the evolution of the national legal framework. Our results identify several priorities for transgender youth who are receiving gender-affirming care. Further research outside hospital networks appears warranted.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":"91-99"},"PeriodicalIF":3.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12976843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145649775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated With Contraceptive Use Among South Asians in New York City.","authors":"Nandini Shroff, Meredith Manze, Sujatha Jesudason, Christian Grov","doi":"10.1111/psrh.70046","DOIUrl":"10.1111/psrh.70046","url":null,"abstract":"<p><strong>Objective: </strong>The limited literature on family planning among Asian populations in the United States suggests that this group underutilizes contraception. We examined factors associated with contraceptive use, particularly among South Asians.</p><p><strong>Methods: </strong>We used cross-sectional data from the 2013, 2014, and 2016 New York City Community Health Surveys and included women and men aged 18-44 years who engaged in sexual activity with a member of a different sex in the last year and did not intend to get pregnant, were not/partner was not pregnant, and could/partner could get pregnant (N = 7101). We conducted bivariate and multivariate logistic regressions with backward elimination to estimate the association between sociodemographic, behavioral, and health care-related factors with the use of any contraceptive at the last sexual encounter. The primary analysis included race as a key independent variable and the secondary analysis was restricted only to South Asians (n = 189).</p><p><strong>Results: </strong>Two thirds of South Asians (67%) used a contraceptive at last sexual encounter. After full adjustment, compared to South Asians, other Asians showed a higher likelihood of using contraception (aOR 1.54; 95% CI: 1.05, 2.26). In the secondary analysis of South Asians, those who were married/living together (aOR 0.19; 95% CI: 0.08, 0.45) or divorced/separated/widowed (aOR 0.14; 95% CI: 0.03, 0.68) showed a lower likelihood of using any contraception compared to those who were never married.</p><p><strong>Conclusion: </strong>Researchers need to conduct additional research to better understand contraceptive behavior among South Asians and identify if/what optimal interventions will increase access and help meet and support their reproductive goals and autonomy.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":"3-15"},"PeriodicalIF":3.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145985730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergency Contraception Provision at Safety-Net Clinics in the Southeastern United States.","authors":"Liwen Zeng, Melissa White-Archer, Jordan de Jong, Michael G Smith, Kris Surles, Rakesh Adelli, Amal Khoury, Kate Beatty","doi":"10.1111/psrh.70054","DOIUrl":"10.1111/psrh.70054","url":null,"abstract":"<p><strong>Introduction: </strong>Emergency contraception (EC) is essential for full-spectrum contraceptive care, preventing unintended pregnancies and promoting reproductive autonomy. Little is known about EC provision at safety-net clinics serving low-income people. This study examines EC provision at health department and federally qualified health center (FQHC) clinics in two United States (US) southeastern states at multiple points in time.</p><p><strong>Methodology: </strong>We analyzed data from statewide surveys of publicly funded family planning clinics assessing the years 2016, 2019, and 2022 in Alabama and South Carolina and key informant interviews with staff at surveyed clinics to assess patterns of EC provision by clinic type over time.</p><p><strong>Results: </strong>Almost all health departments across both states provided EC on-site compared to less than half of FQHCs. Advance provision of EC was less common, with health departments reporting significantly higher rates (2016 = 15.8%; 2019 = 28.7%; 2022 = 15.5%) than FQHCs (2016 = 0%; 2019 = 2.8%; 2022 = 4.3%) (2016, 2019 = p < 0.0001; 2022 p = 0.01). In 2022, 20% of health departments reported providing EC via telehealth compared to 5.1% of FQHCs (p = 0.002). Health department staff noted an increase in advance provision, and FQHC staff noted challenges to provision due to limitations in on-site stocking. EC provision did not change significantly across years.</p><p><strong>Discussion: </strong>Access to EC varies across safety-net clinics in the US South and has not improved over time. Addressing barriers to EC access and providing accurate information about contraceptive methods is essential to empower informed family planning decisions. As reproductive health legislation continues to evolve, expanding access to EC remains critical for safeguarding reproductive health and autonomy.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":"30-38"},"PeriodicalIF":3.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145967153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to \"Research in brief: How prevalent is rough sex? Results from a national online sample of adults in Germany\".","authors":"","doi":"10.1111/psrh.70051","DOIUrl":"10.1111/psrh.70051","url":null,"abstract":"","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":"132"},"PeriodicalIF":3.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145966884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Partners in Contraceptive Choice and Knowledge: Design, Implementation, and Evaluation of a US Statewide Contraceptive Access Initiative.","authors":"Katharine O White, Lillian W Acton, Elizabeth Janiak, Jill Clark, Elizabeth Raskin, Natasha M Lerner","doi":"10.1111/psrh.70053","DOIUrl":"10.1111/psrh.70053","url":null,"abstract":"<p><strong>Objective: </strong>We describe the origin, program design, and evaluation activities of Partners in Contraception Choice and Knowledge (PICCK), a statewide contraceptive access and quality initiative in Massachusetts, United States from 2018 to 2023.</p><p><strong>Methods: </strong>PICCK primarily worked to improve contraceptive care at the state's birth hospitals and their affiliated outpatient practices using a champion model. In addition to hospital-level quality improvement activities, PICCK implemented statewide programming to engage audiences beyond the partnered sites, including a webinar series, annual conference, and resource development.</p><p><strong>Results: </strong>Champions at each hospital led coordination and implementation of customized programming for their site with support from PICCK staff. We conducted presentations and trainings by videoconference when in-person activities were restricted during the COVID-19 pandemic. Implementation periods ranged from 56 to 1323 days (average = 517.5 days). At the statewide level, we conducted 31 webinars, hosted three virtual annual conferences, and created 97 patient- and clinician-facing resources.</p><p><strong>Conclusion: </strong>PICCK was innovative in our dual approach to implementation, with both hospital-based and statewide activities. The structure of PICCK could be adapted to implement other public health quality improvement programs in clinical settings or statewide, given the adaptability and broad reach of the program.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":"120-131"},"PeriodicalIF":3.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146031189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Exploration of the Views and Perspectives of Australian Trans and Gender Diverse Individuals About Transvaginal Ultrasound.","authors":"Caitlyn Wilke, Sav Zwickl, Jane Chalmers, Nayana Parange, Shae Maple, Sarah McMullen-Roach","doi":"10.1111/psrh.70056","DOIUrl":"10.1111/psrh.70056","url":null,"abstract":"<p><strong>Background: </strong>Transvaginal ultrasound (TVS) is used routinely in gynecological care in Australia to manage gynecological health concerns. Typically, TVS is well tolerated by patients, with low levels of discomfort reported. Trans and gender diverse people assigned female at birth may experience gender dysphoria or testosterone-related anatomical changes, which could make such intimate examinations physically difficult or emotionally distressing. However, to date, no studies have considered the impact of gender identity on individuals' experiences of TVS. To fill this research gap, we explored the experiences of TVS among trans and gender diverse individuals assigned female at birth within Australia.</p><p><strong>Methods: </strong>We conducted semi-structured interviews with trans and gender diverse individuals assigned female at birth who have experienced TVS in Australia. We analyzed all interviews in line with Braun and Clarke's reflexive thematic analysis.</p><p><strong>Results: </strong>Ten trans and gender diverse individuals aged between 18 and 50 years old participated in this study. From their interviews, we developed three overarching themes: (1) It's a bit like being a detective, (2) So I could properly say, \"I don't want this done,\" and (3) I definitely felt like a novelty. Participants described a range of positive and negative experiences with TVS, with issues related to cisnormativity in documentation, staff attitudes, and inadequate informed consent consistently highlighted.</p><p><strong>Conclusion: </strong>Trans and gender diverse people face challenges in accessing inclusive gynecological care in Australia. Our findings highlight a need for improved informed consent guidelines, better education and training for health professionals, and more inclusive clinic documentation to promote inclusive care.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":"77-90"},"PeriodicalIF":3.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12976815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146067589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual Functioning and Quality of Life Among Women With Endometriosis: A French Cross-Sectional Survey.","authors":"Alexandre Vallée, Maxence Arutkin, Pierre-François Ceccaldi, Silvia Horsman, Jean-Marc Ayoubi","doi":"10.1111/psrh.70050","DOIUrl":"10.1111/psrh.70050","url":null,"abstract":"<p><strong>Background: </strong>Evidence suggests that symptoms of endometriosis related to sexual dysfunction can disrupt intimate and sexual partnerships. The goal of this study was to understand the association between quality of life and sexual functioning and all its components among women with endometriosis.</p><p><strong>Methods: </strong>We developed an anonymous online survey, which received responses from 1586 French women with endometriosis. We performed multivariable logistic regression to highlight the association between the Female Sexual Functioning Index (FSFI) and its dimensions with quality of life. Interaction analyses allowed subgroup investigation. Adjusted covariables were age, body mass index (BMI), tobacco, education, children, number of symptoms and menopause. We performed logworth analyses to assess the order of the strength relationships between all the components of FSFI.</p><p><strong>Results: </strong>We found that FSFI was mainly associated with quality of life (OR = 1.02 [1.01-1.04], p = 0.002). We observed only two interactions between FSFI and BMI (p = 0.015) and education (p < 0.001). When considering educational subgroups, FSFI level was mainly associated with quality of life among those with a moderate educational level (OR = 1.07 [1.04-1.10], p < 0.001) and when considering BMI subgroups, FSFI level was mainly associated with quality of life among those with a moderate BMI (OR = 1.05 [1.02-1.08], p = 0.002). We did not observe an association between sexual functioning and quality of life among obese and low educational level women. Dyspareunia appeared to be the main component of sexual dysfunction among women with endometriosis (FDR logworth = 9.1, p < 0.001).</p><p><strong>Conclusion: </strong>This study underscores the importance of professionals who treat patients with endometriosis addressing sexual dysfunction to ensure their quality of life.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":"100-107"},"PeriodicalIF":3.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Just Stay Home and Wait It Out\": Exploring Challenges Accessing Care for Miscarriage in Indiana.","authors":"Kathryn J LaRoche, Anayra Maldonado Quiles, Oluwapamimo J Fafowora, Fatimah Lawal","doi":"10.1111/psrh.70057","DOIUrl":"10.1111/psrh.70057","url":null,"abstract":"<p><strong>Introduction: </strong>Qualitative research on miscarriage in the United States primarily draws on the experiences of participants recruited from healthcare settings which may fail to robustly illuminate how people navigate to care. We aimed to explore the miscarriage experiences of Indiana residents, identify barriers to access, and generate recommendations to improve comprehensive miscarriage management and information across the state.</p><p><strong>Methodology: </strong>We used community-based recruitment methods and conducted semi-structured, in-depth interviews with 26 participants who had experienced at least one miscarriage in Indiana between 2018 and 2023. We audio-recorded and transcribed the interviews, and then we used Dedoose to manage our data and carried out content and thematic analysis.</p><p><strong>Results: </strong>Participants described significant challenges locating both information and care about miscarriage. When they reached out to health care providers, women were instructed to \"wait it out\" or go to the emergency department (ED). These recommendations were inconsistent with participants' needs and desires. Participants reflected negatively on their experience at the ED, emphasizing the high financial and emotional costs associated with the visit. Only participants who discovered their pregnancy loss during prenatal care appointments reported being offered active intervention.</p><p><strong>Discussion: </strong>Our findings suggest that some women in Indiana lack access to information and comprehensive treatment options for miscarriage. This funnels non-emergent patients to the ED where patients incur significant financial and emotional costs. Developing strategies to support miscarrying women inside and outside of the ED appears warranted.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":"69-76"},"PeriodicalIF":3.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12976846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146054668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}