Language and cultural barriers to accessing sexual health services

This Sexual Health Week we want to amplify the voices of those who face barriers as well as those who are working tirelessly to break barriers. Paula Wawrzynczyk, Education and Wellbeing Specialist talks about her own experience of accessing services in a new country and Brook’s work with young refugees. 

How did you feel before accessing sexual health services for the first time? Do you remember your thoughts or worries? How would it feel having to do it in a different country where medical professionals don’t speak your language? 

In many parts of the world, sexual health and wellbeing are not popular concepts, and these services can be scarce and difficult to access, especially for young people. In many families, intimate health is not discussed, so parents/carers may not even be aware what their children are going through. Different moral views on young people’s sexual activity make this situation even more challenging to navigate.  

In some countries, sexual health services may be called ‘family planning’ or ‘gynaecology’ and traditionally related to cisgender, heterosexual women’s health.

Men and queer people are less likely to access them – imagine the stigma if homosexuality or expression of gender non-conforming people are criminalised.  

I grew up in Poland where the system is still very much against empowering young people – there is no comprehensive sex education in schools (the government is openly against it) and doctors are not properly trained to talk about sexual health. Free screening for STIs is limited (focused mostly on viral infections like HIV and Hepatitis C) and only the most determined patients will access other tests. When I was younger, to avoid paying for screening, I accessed it through blood donations, but this is not an option for everyone.  

When I moved to London, my journey wasn’t typical – as an experienced sex educator working in international context, I was very curious about sexual health services in the UK.

My awareness and sufficient language skills made these visits smooth and pleasant but most newcomers will need information and support before going to a clinic.  

After working for Brook for 5 years, I’m convinced that the provision in the UK is exceptional and young people friendly. In our clinics, we constantly improve our offer and consult with our clients. Last year, we asked a group of young refugees about how to make sexual health services more approachable for them. These are the questions and issues they raised: 

• What is a sexual health service? Can I access sex there?  
• Will I be judged by medical professionals?  
• Will medical professionals understand my religion?  
• I’m not married, I shouldn’t have sex at all. 
• I’m 17, is it illegal to have sex in the UK?  
• What documents will I be asked to provide? 
• Do we need to have a NHS number? 
• Do I need to pay? 
• What is someone I know sees me in the clinic?  
• Will people gossip about my problem?  

These are questions that need to be addressed. It requires discussing young people’s rights, confidentiality, British approach to sexual freedom and that sexual health services can be accessed by everyone regardless of their documents or immigration status.

When having these conversations, we shouldn’t make any assumptions about young people’s knowledge – some received sex education or educated themselves, some not at all.  

We know that language concordance between patients and providers results in better health care quality and outcomes. Translating tools and interpreting services can greatly improve newcomers’ experience and it’s really important to make sure information is accessible and available in a range of ways so people can choose how to access it. At Brook, we are committed to improving access to young people and we are exploring ways to better support those who speak English as a second language. We are developing new package of resources and for SHW22 we have launched a new sex education glossary that can be found on our free resources page.  

Find out more about Brook’s Sexual Health Week 2022: Breaking Barriers.