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Abstract

This thesis investigates the experiences of Indigenous people in Canada accessing sexual and reproductive health (SRH) services. Indigenous peoples face significant barriers to good health stemming from historical colonization and systemic oppression, which can lead to reluctance in engaging with SRH services. This research was guided by two aims: 1) To examine the existing literature to identify challenges and barriers Indigenous people face when accessing SRH services, and 2) To contribute new quantitative research to the SRH field through the analysis of Indigenous youth health statistics. Chapter 2 of this thesis presents a systematic review of 54 academic and grey literature articles (1993–2023) concerning Indigenous SRH access. Findings reveal that Indigenous peoples experience feelings of shame, fear, and stigma when accessing SRH-related services. Physical barriers include geographic isolation, lack of transportation, and limited access to culturally safe care. The review also notes a recent positive increase in Indigenous community participation and authorship. Chapter 3 examines Indigenous youth reproductive wellness by addressing the question: 'What contributes to negative sexual health outcomes for Indigenous youth aged 12–19?' Using data analysis and logistic regressions from the BC Adolescent Health Survey (BC AHS), findings demonstrate that Adverse Childhood Experience (ACE) factors, such as sexual abuse (Adjusted Odds Ratio 2.93, P. < 0.01) and residential school exposure (AOR 1.77, P. <0.01), play a significant contributing role in negative STI and pregnancy outcomes. Further BC AHS analysis revealed that Indigenous youth constituted 20% of the sexually active cohort who reported an STI. Through weighting and scaling the BC AHS statistics, the estimated STI rate among all sexually active BC youth aged 12–19 was 772.08 per 100,000, which exceeds national reporting averages. Additionally, Queer and Two-Spirit youth represent a disproportionate 25% of all STI cases among this cohort, highlighting a critical need for targeted support (Note: there was a high SE rate). The results emphasize the urgent need for culturally safe SRH services and improved sexual education tailored for Indigenous youth. Two-Spirit and queer identities require increased access to targeted and relevant programming.