Including "sexual" in sexual and reproductive health labor: Gendered experiences of sexually transmitted infection (STI) prevention, testing, and treatment among young people in Texas.
B. Whitfield • Social Science & Medicine (1967) • 2026
Adolescent girls and young women assume the majority of sexual health labor in STI prevention, testing, and treatment, a pattern linked to the sexual double standard and structural neglect of young men in sex education and reproductive health policy.
Key Findings
Results
Adolescent girls and young women bear the majority of sexual health labor related to STI prevention, testing, and treatment.
Based on in-depth interviews with 33 young people ages 15-25 across Texas.
Labor included managing prevention, initiating testing, and coping with emotional and relational consequences of infection.
The study applied a reproductive labor framework to analyze these gendered dynamics.
This unequal distribution extended across all three domains: prevention, testing, and treatment.
Results
The sexual double standard makes testing positive for STIs more consequential for adolescent girls and young women than for adolescent boys and young men.
The greater salience of STIs for girls and young women was linked to the unequal distribution of sexual health labor.
The sexual double standard rendered STI diagnosis more relationally and socially consequential for female participants.
This dynamic appeared to motivate greater engagement in STI-related health behaviors among young women.
Results
Young men's limited engagement in STI prevention reflects broader structural neglect in sex education and reproductive health policy.
Sex education and reproductive health policy in the U.S. have long centered on pregnancy prevention.
This policy focus has historically excluded young men from reproductive and sexual health education.
Young men's disengagement was framed as a product of systemic exclusion rather than solely individual choice.
Results
Young people of all genders were poorly equipped to engage in proactive, communicative approaches to STI prevention.
The finding applied across genders, not only to young men.
Poor preparation was attributed to gendered and heteronormative systems of education and policy.
The study was conducted in Texas, a state with particular constraints on sex education content.
Background
STIs disproportionately burden young people in the U.S., where rates have been persistently high for over a decade.
The study identifies young people as a disproportionately affected population amid an ongoing STI epidemic.
Limited qualitative research has previously explored how young people understand, navigate, and experience STIs.
The study sample included 33 participants ages 15-25 recruited across Texas.
Results
The study extends the concept of reproductive labor beyond fertility and contraception to encompass STI-related care.
This conceptual extension is presented as a key theoretical contribution of the paper.
Gendered and heteronormative systems of education and policy are identified as producing unequal sexual health responsibilities.
The reproductive labor framework was applied to in-depth qualitative interview data.
Conclusions
Comprehensive, inclusive sex education that reframes STI prevention as shared sexual health work is proposed as a strategy to redistribute labor and reduce STI burden.
The recommendation addresses both the gendered imbalance of STI labor and the structural exclusion of young men.
The proposed reframing positions STI prevention as collective rather than individually gendered responsibility.
This conclusion follows from findings that current educational approaches leave all genders underprepared for communicative STI prevention.
What This Means
This research suggests that when it comes to sexually transmitted infections (STIs), young women end up doing most of the work — including researching prevention, arranging testing, and managing the emotional and social fallout of a positive diagnosis — while young men are much less involved. The study interviewed 33 young people between ages 15 and 25 across Texas and found that this imbalance is not simply a matter of personal choice. Instead, it is shaped by social norms that judge young women more harshly for STIs, and by sex education and health policies that have historically focused on pregnancy prevention and largely left young men out of the conversation about sexual health.
This research suggests that because STI prevention has been treated mainly as a women's issue — both culturally and in policy — young men are not given the knowledge or expectation to be active participants in protecting their own or their partners' sexual health. At the same time, young women carry a heavier burden because a positive STI diagnosis can damage their social reputation in ways it typically does not for young men. The study frames this pattern as a form of 'reproductive labor' — unpaid, often invisible work that falls disproportionately on women — and extends that concept beyond contraception to include STI care.
This research suggests that redesigning sex education to treat STI prevention as shared responsibility, rather than primarily a female concern, could help distribute this burden more equally and potentially reduce STI rates among young people. The findings point to a need for policies and educational programs that explicitly include young men and move beyond a narrow focus on pregnancy prevention toward a broader vision of sexual health as a collective, communicative practice.
B. Whitfield. (2026). Including "sexual" in sexual and reproductive health labor: Gendered experiences of sexually transmitted infection (STI) prevention, testing, and treatment among young people in Texas.. Social Science & Medicine (1967). https://doi.org/10.1016/j.socscimed.2026.119386