research and consultation papers

Sexual and Reproductive Health Needs of Young Adult Sex Workers


Youth who exchange or sell sexual services experience significant disparities with regard to sexual health status, sexual health risk behaviours, and access to sexual and reproductive health care.  Planned Parenthood Toronto, together with Maggie’s: Toronto Sex Workers’ Action Project and researchers from the University of Toronto, conducted a community-based research project to better understand young adult (age 18-29) sex workers’ sexual and reproductive health needs. The project included focus groups and interviews with 18 young adult sex workers and an online survey with 62 respondents, for a total of 80 participants.


Download our 7 Recommendations for Healthcare Providers here.



Trans and Nonbinary Youth Inclusivity in Sexual Health Guidelines

We are very excited to share these new guidelines for including trans and nonbinary youth in sexual health with you, and that you are interested in learning more about affirming the wide range of gender identities of youth you work with!


Why are these guidelines important?

Trans and nonbinary youth experience challenges accessing sexual health services and sex education that validates their unique gender identities and bodies.  As a result, some trans people avoid seeking necessary sexual health services, or feel left out of sexual health education materials and conversations.  At the same time, many sexual health service providers and educators feel unprepared to work with trans people, or worry about making a mistake due to being uninformed.

We believe that trans and nonbinary youth deserve to be included in sexual health information, resources and services across the board.


Who are these guidelines intended for, and what is their purpose?

These guidelines are intended for sexual health service providers and educators who want to better include trans and nonbinary youth in their work. We hope that this document will help service providers and educators feel more knowledgeable about trans identities, so that youth can access services and education that accurately reflect their experiences. These guidelines are not meant to be used as a resource for specific medical information, or as lesson plans to teach about trans and nonbinary youth inclusivity.  Rather, this document serves as an introduction on how to improve your practice, informed by real life examples told from the perspectives of trans and nonbinary youth.


How were these guidelines created?

These guidelines were created through a community-based research project led by Planned Parenthood Toronto, with guidance and input from a youth advisory committee (YAC) of 8 diverse trans and nonbinary youth ages 16-29. The YAC played a key role in all stages of the project, but especially in determining what information to prioritize in the guidelines. The goal of this project was to develop solutions to increase the inclusion of trans youth in sexual health education by developing guidelines and language around sexual health that include diverse  trans identities, bodies and experiences.


Initially, content for these guidelines was developed based on focus groups we held with 18 trans and nonbinary youth, as well as individual interviews with 7 sexual health service providers and educators in Toronto. We then held a town hall in which approximately 60 service providers, educators, and community members provided feedback on the guidelines. After incorporating this feedback, we conducted another round of focus groups with 8 trans and nonbinary youth and 7 service providers and educators to gather final recommendations prior to finalizing the document.


A diverse range of youth participated in the project focus groups. Participants’ gender identities included trans feminine, trans masculine, nonbinary, bigender, and two-spirit among others. Their sexual identities included bisexual, queer, gay or lesbian, heterosexual, pansexual, asexual and more. Participants also identified with a range of racial and cultural identities, including white, Black, Aboriginal, Jewish, Chinese, Southeast Asian, South Asian, West Asian, and Arab.


What are the limitations of these guidelines?

While we do see this as a useful starting point for increased trans and nonbinary inclusivity in sexual health service provision and education, we recognize that these guidelines may not represent the identities and experiences of all youth. For example, the perspectives of youth who did not feel comfortable participating in focus groups or who do not live in Toronto may not be represented in this document. Further, group dynamics of focus groups can sometimes make it difficult for some members to be heard. As such, these guidelines should not be seen as a replacement for individual conversations between youth and service providers or educators.


Download the Guidelines Here


Understanding the Sexual and Reproductive Health Needs of Young Bisexual Women in Toronto: A Community-Based Research Project (Ongoing)
We took on this research project because we know that young bisexual women experience a number of disparities and differences around sexual health compared to their heterosexual and lesbian peers. This includes higher rates of teen pregnancy, lower rates of condom use for vaginal sex, more sexual partners, and higher rates of anal sex. Just to be clear – although some research may talk about things like anal sex and higher numbers of sexual partners as risks or problems, in this research project and at Planned Parenthood Toronto, that isn’t the approach we take. We support young bisexual women in the sexual choices they make, and want to better understand what services and information they need in order to make informed choices for themselves and take care of their sexual health in ways that work for them.


The goal of this particular research project is to improve sexual and reproductive health for young bisexual women by increasing understanding of their sexual and reproductive health needs, exploring how they understand the sexual and reproductive health disparities that disproportionately affect them and their peers, and listening to their recommendations for making positive change in sexual health services and education. We heard from 35 young bisexual women through four focus groups which took place in 2014, and were guided in the overall research process by an advisory committee of young bisexual women.


This project was undertaken in partnership with the Factor-Inwentash Faculty of Social Work at University of Toronto and the Re:searching for LGBTQ Health team at the Centre for Addiction and Mental Health, with funding from the Women’s College Hospital Women’s Xchange 15K Challenge.


For information on our findings, check out the links below:



More findings will be posted as additional fact sheets, articles, and other materials are finalized.



Toronto Teen Survey (2009)

Community-based organizations need increased support to provide relevant, inclusive and appropriate programming aimed at improving sexual health outcomes for the youth they serve. The increase in HIV and STI rates, and decrease in sexual health knowledge among youth, combined with the multiple and ever-changing needs of Toronto’s diverse youth communities, demonstrate a need to change the current state of sexual health services and information available to youth. In 2009, Planned Parenthood Toronto released the Toronto Teen Survey (TTS), the result of a long research process to help enrich both the quality and quantity of sexual health information available to Toronto teens and improve the ways in which sexual health promotion and care are delivered. Specific objectives of the report include:


We adopted a community-based participatory research approach and involved teens in all aspects of the study. Between December 2006 and August 2007, we conducted 90 workshops in community-based settings, collecting 1,216 surveys from a diverse cross-section of youth ages 13 to 18+. As one of the largest and most diverse studies of young people’s sexual health needs ever done in Canada, TTS provided a space for youth voices that are often unheard. In 2008, we held 13 focus groups with 80 service providers representing 55 agencies to discuss the research findings and brainstorm recommendations for change.



Consultation Papers
Shelter and Group Home Consultation

Improving Access for Newcomer Youth to Sexual Health Resources and Services