Table 3 The categorization of the concerns mentioned by participants in the included studies
Category | Examples | Number of codes |
|---|---|---|
Being controlled | Being monitored by staff in instructions, lack of privacy | 6 |
Education | Inadequacy of school-based sexuality education, being prohibited from participating in sexuality education, lack of training programs for staff and families | 9 |
Knowledge and skills | Limited knowledge of STDs, unwanted pregnancies, rights, genders roles, sexual identity, self-protection, female and male anatomy, and contraceptive options | 24 |
Sexual abuse | Sexual abuse in different ways (i.e., internet, manipulation, verbal) and in different settings such as public places, difficulty reporting abuse, difficulty refusing unwanted sexual intercourse, sexual harassment, fear of financial exploitation | 16 |
Information | Lack of literacy and needed skills to seek information independently, limited sexual health resources | 5 |
Lack of support to find a partner | Limited support from caretakers, family disagreement, receiving less parental support, reliance on others for supports, lack of trust among parents, lack of consent from parents, parents’ concern about getting pregnant, lack of support to engage in a relationship and access to a meeting place | 9 |
Shyness | Loving person in secret, being embarrassed to talk about sexual issues, shyness in expressing feelings | 10 |
Anxiety and fear | Fear of sex, fear of first sexual act, concern about unwanted pregnancy, concern about isolation and sterilization, psychological concerns, concern of negative sexual experiences, fear of STDs, | 26 |
Communication | Difficulty with expressing views and specifying needs, not being able to talk about sexuality | 6 |
Sociocultural barriers | Social isolation, prohibition of sexual expression, negative reactions from staff, families and public, being viewed as an emotionless, being sexually inactive, religious beliefs, | 9 |
Limited experiences | Lack of exposure to sexuality, Lack of pleasure | 3 |
Poor understanding | difficulty with understanding sexual orientation, societal norms, emotional feelings, sexual needs | 6 |
Intellectual capacities | Forgetting what has been learned, not being in a relationship due to disability, inappropriate sexual behaviors, problem with remembering issues | 6 |