“We Want Our Therapist to Talk With Us About Sexuality and Gender Diversity”: Qualitative Perspectives of Adolescents and Professionals in Youth Mental Health Care

AimsYouth receiving mental health care often face challenges related to romantic relationships, sexuality, and sexual orientation and gender identity (SOGI). Although widely recognized as relevant, these topics are infrequently addressed in youth mental health care. This study explored how youth and mental health professionals experience discussions about sexuality and SOGI in clinical practice.MethodsIn-depth interviews were conducted with 21 youth aged 15-22 years receiving psychiatric care, alongside three focus groups with 20 mental health professionals, at a youth mental health center. Data were analyzed using thematic analysis.ResultsYouth described romance, sexuality, and identity as a normal part of life and closely linked to their well-being, while mental health difficulties often complicated relationships and identity processes. Professionals reported hesitation in raising these topics due to practical and personal barriers. Cultural and religious contexts shaped experiences, particularly for LGBTQ+ youth. Both groups emphasized the importance of addressing sexual side effects of psychotropic medication.ConclusionThis study highlights a gap between the recognized relevance of sexuality and SOGI and their discussion in everyday practice. Youth want these topics addressed in mental health care conversations. Bridging this gap requires proactive, youth-centered and culturally sensitive communication, supported by training and institutional attention.