Katie, a 29-year-old retail worker, was searching for an alternative to the birth control pill. A few months ago, she went to a walk-in clinic in Toronto to inquire about the copper intra-uterine device (IUD), a more affordable, non-hormonal birth control option. She figured it would be safe to address sexual matters with her doctor, also a young woman. To Katie’s surprise, the doctor claimed that IUDs are “only for older, monogamous, married women” – end of conversation.

For the record, there is no solid evidence to suggest that younger, non-monogamous women can’t have an IUD – I have one, and I am an unwed 24-year-old. Rather than shutting that door because Katie did not fit her ideals, the doctor should have properly counseled Katie on risks and benefits, or referred her appropriately. As a result of this neglect, Katie left the clinic feeling judged, frustrated, and discouraged.

Katie’s story is not an isolated case. In Canada, youth face numerous and varying obstacles to accessing comprehensive and equitable sexual health services. One issue is that in the country’s health care network, there seems to be a tendency to treat sexual health as separate from primary, everyday care. In reality, taking care of your sexual health is as much a factor in your overall well-being as, say, balanced eating or physical activity. This separation is manifested literally, with a limited number of designated clinics that specialize in sexual health. For LGBTQ2I youth, accessibility is further impeded by discriminatory health care practices. And if you live outside of a big city that can pose its own set of challenges.

While you can turn to your general practitioner for most health issues, for which they can either care for themselves or refer you to a specialist, disclosing details surrounding your sexuality is often more difficult. Mimi, a sexual health peer educator, says, “Young people are reluctant to discuss sex with their doctors for many reasons.” For starters, sex can be too sensitive a subject to discuss with anyone, let alone with a family practitioner that you’ve been seeing since you were in diapers – or, conversely, that you’re meeting for the first time. Maybe you’re worried that your doc will pass judgment on your sexual preferences. If you’re a trans youth, your reluctance may stem from scarring experiences with transphobic practitioners.

Traditional medical settings like family clinics and hospitals compound these anxieties by treating sex as a taboo subject. “We don’t even use the right terminology around sexual health,” says family physician Dr. Sheila Wijayasinghe. “Doctors are taught to use euphemisms to make people comfortable, but at the same time we perpetuate the stigma around [discussing sex].”