B.C. Youth Demand Inclusive, Stigma-Free Sexual Health Care

A research team at the University of British Columbia and Options for Sexual Health spent months listening to young people across British Columbia describe what they need from sexual health care—and what they're not getting. The findings, released this summer, paint a picture of a generation caught between expanding provincial services and persistent gaps in access, particularly in rural and remote corners of the province.

The study involved 91 young people aged 15 to 29 and 47 sexual health-care providers, with researchers conducting interviews in eight distinct regions: Fernie, Vernon, Whistler, Maple Ridge, the Comox Valley, Salt Spring Island, the Clayoquot Sound region, and newcomer communities in the Lower Mainland. What emerged was a consistent message. Young people want sexual health care that feels safe, inclusive, and designed with them in mind—spaces where providers understand their lives, take time to build trust, and create an atmosphere free from judgment.

On paper, British Columbia has made real progress. Over the past decade, the province introduced mail-order cancer screening, expanded access to abortion medication, made all contraceptives free and available through pharmacists, and launched GetCheckedOnline, which lets people screen for sexually transmitted infections without showing identification. Yet despite these advances, rates of STIs, sexual violence, unplanned pregnancies, and early parenthood remain disproportionately high in rural, remote, and underserved communities. The gap between policy and lived experience persists.

One of the report's most striking findings concerns sex education itself. Young people today, according to Rachel Bergen, the sexual health evaluation project lead at UBC, do not know significantly more about sexual health than their counterparts did a decade or two ago. While sex education is mandated in B.C. schools, it remains inconsistent—sometimes absent entirely. When it does happen, it often centers heterosexual relationships and relies on fear and shame rather than honest, inclusive information. Young people told researchers they would overwhelmingly prefer to learn from external, specialized sexual health educators rather than classroom teachers, many of whom receive no training in this subject during their pre-service education.

The information landscape adds another layer of confusion. Young people report feeling overwhelmed by the sheer volume of sexual health content online, uncertain which sources to trust, and vulnerable to misinformation and frightening anecdotes circulating on social media. Bergen noted that this uncertainty matters deeply because sexual and reproductive health are foundational to well-being, particularly for young people navigating development and making decisions that shape their futures.

Access itself presents a concrete barrier, especially in small towns. Young people don't always know what services exist or how to reach them. Transportation can be difficult. Privacy is a genuine concern—in communities where the only pharmacist is someone's parent, confidentiality feels impossible. Yet providers can deliver many sexual health services—information, education, contraception, STI screening and treatment, cancer screening, abortion care, pregnancy care—without a clinical exam, as long as the patient is not symptomatic. This opens possibilities for bringing care to where young people already gather: schools, youth centers, community spaces.

The Comox Valley offers a working example. Public health nurses visit high schools and Foundry youth clinics once a week for a couple of hours, making sexual health services accessible without requiring young people to navigate unfamiliar clinical settings or worry about being seen entering a doctor's office. Nicole Pasquino, a registered nurse and clinical director at Options for Sexual Health, emphasized that pop-up clinics can protect confidentiality in ways traditional clinics cannot. She also clarified an important legal point: in British Columbia, there is no fixed age at which young people suddenly need parental permission for sexual health care. Instead, providers assess whether a young person has the emotional and decision-making capacity to consent. A 13-year-old can access care without parental approval if they demonstrate informed consent. Young people are encouraged but not required to involve their parents.

The report's recommendations point toward a shift in how existing services are delivered rather than wholesale reinvention. Young people want one-stop-shop support—primary care, mental health services, and sexual health care in the same location. They want spaces that feel welcoming and culturally safe. They want providers who are comfortable discussing sex, which means not all doctors will suffice; accessible sexual health services become essential, particularly in small communities where options are limited. This fall, two pilot projects will test delivering sexual health care in multi-use community spaces rather than traditional clinical settings. The locations will be announced in September. What happens in those spaces will shape how the province thinks about reaching young people where they actually are.