The representation of women who have sex with women (WSW) in sexual health promotion in England: a frame analysis

Background: Women who have sex with women (WSW) are a marginalised group. WSW are assumed to be at low risk of sexually transmitted infections (STIs). However, they have similar rates of STIs to women who have sex exclusively with men. A lack of accurate and relevant sexual health information for WSW has been identified and highlighted as a barrier to good sexual health in this group. This study aims to explore how WSW and their STI risk are represented in sexual health promotion in England. Methods: Organisations that produced sexual health promotion campaigns or policy were identified using a three-step Google search. Up to three materials from each campaign were chosen for analysis alongside policy documents. Frame analysis was used to identify and develop a thematic framework that identified common themes and assumptions in the data. Results: 5 policy documents and 42 campaign materials were analysed (n=47). Nine frames were identified and used to discuss the two overarching themes that emerged from these: over-representation of the penis and under-representation of WSW and their relevant sexual practices. Discussion: This study suggests an androcentric and heteronormative framing of sexual health promotion, resulting in the erasure of WSW. Erasure perpetuates false narratives of low STI risk and symbolically annihilates this group, a form of symbolic violence. To address this issue, I suggest empowering WSW by acknowledging this erasure and developing new sexual health campaigns and policy with the participation of this group.