Digital health technologies used for sexual and reproductive health services can cause or perpetuate emotional trauma through platform design features and interpersonal interactions, with greater harm occurring among individuals with prior traumatic experiences.
Key Findings
Results
Technology-related harm in sexual and reproductive health digital platforms occurs through two main pathways: digital platform design features and digital platform-related interpersonal interactions.
Design features contributing to harm included navigation challenges, data and security breaches, and inappropriate display of content.
Interpersonal interaction harms included targeted campaigns and depersonalized digital health interactions.
The study used Charmaz constructivist grounded theory with 25 participants who had used government and other regulated digital health platforms.
Platforms studied included web-based platforms and mHealth apps used to access STI testing, contraception, and abortion services.
Results
The severity of harm from technology-related trauma differs based on users' prior traumatic experiences.
Individuals with prior traumatic experiences were more likely to experience emotional trauma from technology-related harms.
Individuals without prior traumatic histories were more likely to experience emotional discomfort rather than full emotional trauma.
This pattern was particularly salient for individuals from equity-deserving populations who already navigate stigma, discrimination, or prior traumatic experiences in health care settings.
Methods
An explanatory theoretical model of technology-related trauma in sexual and reproductive health digital platforms was developed using constructivist grounded theory.
The study conducted interviews with 25 participants who had used regulated digital health platforms for sexual and reproductive health services.
Data analysis occurred alongside data collection using open, axial, and theoretical coding.
The Charmaz constructivist grounded theory approach was used to develop the theoretical account.
The model accounts for both unintentional harms via design choices and more intentional technology-related interactions that trigger or perpetuate trauma.
Results
Digital health technologies used for sexual and reproductive health can serve as conduits through which trauma can be triggered, perpetuated, and exacerbated.
While web-based platforms provide opportunities for advancing access to sexual and reproductive health services, they simultaneously carry risk of trauma.
Technology-related trauma could occur unintentionally via design choices.
Some technology-related interactions could intentionally or unintentionally trigger or perpetuate trauma among end users.
Services facilitated by these platforms include contraception counseling, abortion care, STI testing and treatment, and fertility-related support.
Discussion
Both technology developers and health providers are identified as responsible parties for mitigating technology-related trauma risks in sexual and reproductive health platforms.
The study recommends that technology designers consider design choices that not only prevent trauma but also promote users' emotional well-being.
Health providers are also identified as needing to consider implementation strategies to reduce trauma risk.
The risk of trauma is described as particularly salient for individuals from equity-deserving populations.
The authors call for trauma-informed approaches to both design and implementation of digital sexual and reproductive health platforms.
What This Means
This research suggests that digital health tools used for sexual and reproductive health services — such as apps and websites for STI testing, contraception, and abortion — can accidentally cause or worsen emotional trauma in users. Researchers interviewed 25 people who had used these kinds of platforms and identified two main ways harm occurs: through the way platforms are designed (such as confusing navigation, privacy breaches, or disturbing content being shown unexpectedly) and through how people interact with these platforms (such as receiving targeted advertising or feeling like they are treated as anonymous rather than as a real person). People who had experienced trauma before — particularly those from marginalized communities who already face stigma or discrimination in healthcare — were more likely to experience serious emotional trauma from these digital interactions, while others without such histories were more likely to experience discomfort but not full trauma.
This research suggests that the design of digital health platforms is not a neutral technical matter but has real emotional consequences for users, especially vulnerable populations. Small decisions made by developers — like how information is displayed, how data is protected, or how automated messages are sent — can inadvertently re-traumatize people who are already in vulnerable situations seeking sensitive health care. The study developed a theoretical model to help explain how and why this happens, which could guide more trauma-aware approaches to building and deploying these tools.
Practically, this research suggests that both the companies building sexual and reproductive health apps and the healthcare providers using them need to think carefully about trauma-informed design and implementation. Rather than simply making platforms functional and accessible, developers should actively work to prevent triggering trauma responses and to support users' emotional well-being throughout their digital health experience.
Abdulai A, Josephs J, Guta A, Gilbert M, Bungay V. (2025). Technology-Related Trauma in Sexual and Reproductive Health Digital Technologies: Grounded Theory Study.. JMIR formative research. https://doi.org/10.2196/79365