Swedish youth clinics largely operate within a gender-neutral framework that fails to address boys and young men's specific needs, with BYM accounting for only 9.5% of clinic visits despite 87% of clinics expressing dissatisfaction with this level.
Key Findings
Results
Boys and young men (BYM) accounted for only 9.5% of youth clinic visits in Sweden.
The survey was distributed to all 240 youth clinics in Sweden between September and November 2024.
75 responses were received, representing 110 clinics, corresponding to a 45% clinic-level response rate.
87% of clinics expressed dissatisfaction with the level of BYM attendance.
This underrepresentation persists despite Sweden's universalist health model offering free sexual and reproductive health (SRH) services.
Results
Only 58% of clinics reported using strategies to attract BYM, and only 34% of those using strategies evaluated their effectiveness.
Institutionalization of strategies was described as limited.
Implementation remained inconsistent and often project-based rather than systematically embedded.
24 follow-up unstructured interviews were conducted to supplement survey findings.
Qualitative data were analyzed using inductive content analysis.
Results
Four main strategy categories were identified among clinics attempting to improve BYM access.
The four categories were: (1) staff capacity-building for male-inclusive care, (2) environmental adaptations to create inclusive spaces, (3) digital outreach and marketing to enhance visibility, and (4) collaboration with schools and community settings to reach BYM.
These categories emerged through inductive content analysis of open-ended survey responses and interview data.
Clinics using strategies were more likely to report increased male attendance.
This study represents the first national-level mapping of such strategies in Sweden.
Background
Structural and cultural barriers including masculine norms and female-oriented service environments contribute to BYM underrepresentation at youth clinics.
Limited institutional guidance for engaging male adolescents was identified as a contributing factor.
Swedish youth clinics largely operate within a gender-neutral framework that fails to address BYM's specific needs.
Prior efforts to improve BYM access had not been systematically documented or evaluated before this study.
The study identifies a need for a shift toward gender-responsive care anchored in policy, training, and service design.
Conclusions
National coordination, standardized guidelines, and equity monitoring were identified as essential recommendations to ensure BYM benefit equally from youth health services.
The authors call for a shift toward gender-responsive care rather than the current gender-neutral framework.
Policy-level anchoring of training and service design changes was emphasized.
The study contributes to global discussions on inclusive, adolescent-centered SRH care.
The findings underscore that project-based approaches are insufficient for sustained change.
What This Means
This research suggests that Sweden's free youth health clinics, which provide sexual and reproductive health services, are largely being used by girls and young women while boys and young men (BYM) make up only about 1 in 10 visitors. Despite the fact that these services are available to everyone at no cost, the vast majority of clinics (87%) said they were unhappy with how few male youth were coming in. The researchers surveyed all 240 youth clinics in Sweden and followed up with interviews at 24 clinics to understand what, if anything, clinics were doing to address this imbalance.
The study found that while just over half of clinics were trying some strategies to attract more male youth, very few were formally evaluating whether those strategies worked, and most efforts were inconsistent or temporary rather than built into standard practice. The strategies being used fell into four broad categories: training staff to be more welcoming to male clients, changing the physical environment to feel less exclusively female-oriented, using digital tools and social media for outreach, and partnering with schools and community organizations. Clinics that were actively using these strategies did tend to report seeing more male visitors, suggesting the approaches can help.
This research suggests that the current 'gender-neutral' approach used by most Swedish youth clinics in practice does not serve boys and young men equally, because the default environment and culture of these clinics has historically centered female needs. The authors argue that meaningful change would require national-level policy support, standardized training guidelines, and ongoing tracking of who is actually using these services — so that gaps like this one do not go unaddressed.
M. Tetui, Emma Bernard Stenmalm, Mazen Baroudi. (2026). Mapping the strategies to address the gender gap in youth clinic utilization in Sweden; explorative survey and follow up interviews. Archives of public health = Archives belges de sante publique. https://doi.org/10.1186/s13690-026-01918-y