| dc.description.abstract | Sexual health is an important part of public health’s mandate, especially when working with young adults who are experiencing great physiological and psycho-social development and change. The World Health’s Organization’s (2024) definition of sexual health encompasses physical, emotional and social wellbeing, yet is best understood within the larger definition of sexuality. Hence, sexuality is conceptualized as an individual’s attitudes, thoughts, behaviors, identities and relationships as shaped and influenced by biological, psychological, social, political, cultural and religious factors. Using this definition therefore means that how sexuality is defined and enacted will vary based on time, place and social context.
Quantitative research has traditionally dominated public health’s examination and assessment of sexuality, with a concentration on individual behaviors and risk outcome measures. Much less public health research has focused on how individuals and groups subjectively experience their sexuality, including positive aspects of sexual wellbeing. Notably, women’s subjective experience of sexuality has been underrepresented given the long-standing history of gender inequality. Traditional social norms and practices for women have resulted in inadequate access to sexual health information and services, limited decision-making power in their sexual behavior and increased vulnerability in sexual violence. Due to the stark reality of these health inequalities, it is important to capture diverse women’s voices in sexuality research so that institutional programs and policies meet their needs and do not contribute to gender bias, stigmatization and discrimination.
Utilizing a social constructionist theoretical lens, the overarching purpose of this dissertation research is to develop an understanding of how young women conceptualize sexuality in Ontario, Canada. This dissertation is separated into three papers, each drawing from the same study and research questions but having their own distinct aim. Paper one examines the constructed meanings and lived experiences of young women’s sexuality as situated within gender roles, norms, identities and scripts. Paper two understands how young women construct, negotiate and/or challenge a dominant risk narrative of sexuality. Paper three takes a methodological focus to explore the use of photo-elicitation for the construction of sexuality narratives. Taken together, these papers make empirical, theoretical and methodological contributions.
The study employed a qualitative approach to sexuality research through narrative methodology. Purposive sampling recruited thirteen young women from Ontario, aged 18-24 years. The women participated in 1-2 virtual interviews, in addition to incorporating a visual method known as photo-elicitation. Using a broad definition of ‘photo’, participants used self-chosen pictures, art, advertisements, memes or online images as prompts to elicit memory recall and/or more detailed stories of their sexuality. Data collection, analysis and interpretation was an iterative process to co-construct narratives between researcher and participant. Employing thematic analysis of narratives, the focus was on content of narratives to identify common categories and characteristics. In paper 1 and 2, themes were interpreted across young women to understand what their personal stories revealed about current socio-cultural context. Paper 3 examined themes within only one participant’s narratives, as a case-study example for methodological discussion.
Narratives in paper one revealed five themes about how young women gave meaning to and experienced their sexuality within current gender norms, identities and scripts, which included: 1) imposed identity labels, 2) expected feminine presentation, 3) submission and servitude, 4) objectification and victimization, and 5) pleasure. These themes constructed an overall narrative across young women that their sexuality was often not seen as their own. In paper two, young women narrated physical and psychosocial risks of sexuality, with four themes emerging: 1) experiencing slut-shaming, 2) disappointing parents, 3) responding to sexual violence (feared or realized), and 4) not measuring up to peers. Across young women, sexuality continues to be situated within a discourse of risk, as constructed through social institutions including family, education, healthcare and media. The third paper summarized my journey, as the researcher, utilizing photo-elicitation (PE) for the co-construction of sexuality narratives. Highlighted are research considerations, including practical and ethical issues of collecting photos of a sensitive nature and using photos when considering anonymity and confidentiality. Findings demonstrate that PE can be used to explore and make meaning of contradictory and complex narratives that are reflections of societal and cultural norms and assumptions. Overall, PE is a useful visual methodology when working with underrepresented groups and creating a collaborative participant-researcher relationship.
The present research study demonstrated that young women conceptualized their sexuality as something that was predominantly defined and judged by others, and not always experienced as something they control or enjoy for themselves. This reflects prominent historical, social and cultural gender norms, expectations and scripts for women that perpetuate gendered sexual stereotypes and oppression. Additionally, young women conceptualized sexuality predominantly through its negative outcomes (e.g. sexual violence), with much less focus on positive aspects (e.g. pleasure). Some women countered dominant narratives of risk through stories of resistance, however many more women normalized the gendered nature of risk and often felt powerless against the status quo.
Conclusions drawn from this study feel troubling given the WHO’s definition of sexuality stresses autonomy and pleasurable sexual experiences. As a primary site that socially constructs and reconstructs gender and sexuality, educational institutions including school curriculum, have a pivotal role to play in countering gender ideologies in order to support diversity, equality and acceptance. Within public health and health care, a focus on pleasure as a sexual right for all, is imperative to advancing gender equality and promoting sexual behaviors that are respectful, safe and non-coercive. Future research should continue to explore meanings and experiences of sexuality not only for women, but also men and gender-diverse individuals, as this will help assess whether progress is being made towards deconstructing traditional gender norms and expectations. Additional research should use an intersectional analysis approach to understand not only gender, but the intersections of gender with other social identities and the role of power relations in health inequalities. | en |
