Sexual Health Research for and with Urban Youth: The Toronto Teen Survey Story
Flicker, Sarah, Travers, Robb, Flynn, Susan, Larkin, June, Guta, Adrian, Salehi, Roxana, Pole, Jason D., Layne, Crystal, The Canadian Journal of Human Sexuality
Abstract: This article provides an overview of the development and implementation of the Toronto Teen Survey (TTS). The TTS was a partnership between Planned Parenthood Toronto and a network of academic researchers. The primary objective of the TTS was to assess the sexual health education needs and service access barriers among youth living in one of the most ethno-racially diverse cities in the world. The TTS used a community-based research approach that involved youth as full partners in the project.
The Toronto Teen Survey (TTS) sought to explore assets, gaps, and barriers that currently exist in sexual health education and related services for urban youth. The large study sample was diverse in terms of ethno-cultural background, immigration history, religion, and sexual self-identification and was thus characteristic of urban youth in Toronto. The focus of TTS is on diversity, equity and adolescent sexual health. This article reflects these themes and documents the story of the Toronto Teen Survey.
Toronto is one of the world's most ethno-racially diverse cities, home to more than 80 ethnic groups speaking over 100 languages. For many years, Ontario has been the destination for over half of all immigrants to Canada; Toronto has received a sizeable portion of that influx. Changes in immigration policy concerning source countries contributed to the growth of youth communities that were varied in terms of race, culture, and language. As this trend unfolded, community-based organizations across the city recognized gaps in their capacity to offer culturally effective sexual health education and promotion services. Planned Parenthood Toronto (PPT), a community health centre offering a variety of clinical and health promotion services to individuals in the Toronto area, found itself increasingly called upon by sister organizations to help them build capacity and to develop effective sexual health services for their particular youth populations.
Since its inception in 1961, PPT has evolved by developing programs and services that kept pace with complex and changing community needs in the area of sexual and reproductive health. The changing face of those needs prompted PPT's strategic plan (2003-2005) which sought to increase positive sexual health outcomes for youth and to decrease the barriers to sexual health programs and services encountered in youth communities. To this end, PPT reached out to build partnerships with a network of academic researchers with expertise in youth sexual health research. Our goal as a community-university research team was to explore how best to use research to assess the sexual health needs of diverse groups of youth, to identify the service access barriers they might experience, and to suggest recommendations for best practices for ensuring their overall sexual health. The eventual result of this collaboration was the Toronto Teen Survey.
In our preliminary discussions, we quickly noted that there is no shortage of research documenting teen sexual behaviour, but the focus of this research is limited. As Michelle Fine has aptly written, "Today we can "Google" for information about the average young woman's age of "sexual debut," if she used a condom, got pregnant, the number of partners she had, if she aborted or gave birth and what the baby weighed. However, we don't know if she enjoyed it, wanted it, or if she was violently coerced" (Fine & McClelland, 2006, p. 300). We think this perception also applies in the Canadian context and would add that we also probably would not know, particularly for diverse populations of urban youth, whether a young woman had support, adequate sexual health information about options to protect herself, or other information or resources to deal with the complex and important sexual milestones that young people encounter. Furthermore, behavioural studies of youth have tended to under-represent some populations of youth (e. …