Department of Psychiatry, Women's College Hospital, Canada; Department of Psychiatry, University of Toronto, Canada; and Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
Department of Psychiatry, Women's College Hospital, Toronto, Canada
Ananka Rodriguez
Slaight Centre Early Intervention Service, Centre for Addiction and Mental Health, Toronto, Canada
Shakked Lubotzky-Gete
Department of Psychiatry, Women's College Hospital, Toronto, Canada
Suze Berkhout
Department of Psychiatry, University of Toronto, Canada; and Department of Psychiatry, University Health Network, Toronto, Canada
Robert Dmytryshyn
Family Practice Health Centre, Women's College Hospital, Toronto, Canada; and Department of Family and Community Medicine, University of Toronto, Canada
Sheila Dunn
Family Practice Health Centre, Women's College Hospital, Toronto, Canada; and Department of Family and Community Medicine, University of Toronto, Canada
Renu Gupta
Department of Psychiatry, Women's College Hospital, Toronto, Canada; and Department of Psychiatry, University of Toronto, Canada
Fardous Hosseiny
Canadian Mental Health Association, Toronto, Canada; Atlas Institute for Veterans and Families, Ottawa, Canada; and University of Ottawa Institute of Mental Health Research at The Royal, Ottawa, Canada
Frank Sirotich
Canadian Mental Health Association, Toronto, Canada; and Factor-Inwentash Faculty of Social Work, University of Toronto, Canada
Department of Psychiatry, University of Toronto, Canada; Department of Family and Community Medicine, University of Toronto, Canada; and Education, Centre for Addiction and Mental Health, Toronto, Canada
Aristotle Voineskos
Department of Psychiatry, University of Toronto, Canada; and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
Department of Psychiatry, University of Toronto, Canada; and Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
Background Women and gender-diverse people with early psychosis are at risk for suboptimal sexual health outcomes, yet little research has explored their sexual health experiences. Aims This study explored sexual health experiences and related priorities among women and gender-diverse people with early psychosis, to identify opportunities for improvements in sexual health and well-being. Method Semi-structured individual qualitative interviews explored how patient participants (n = 19, aged 18–31 years, cisgender and transgender women and non-binary individuals) receiving clinical care from early psychosis programmes in Ontario, Canada, experienced their sexual health, including sexual function and behaviour. Thematic analysis was conducted, with triangulation from interviews/focus groups with clinicians (n = 36) who provide sexual and mental healthcare for this population. Results Three key themes were identified based on patient interviews: theme 1 was the impact of psychotic illness and its treatments on sexual function and activity, including variable changes in sex drive, attitudes and behaviours during acute psychosis, vulnerability to trauma and medications; theme 2 related to intimacy and sexual relationships in the context of psychosis, with bidirectional effects between relationships and mental health; and theme 3 comprised autonomy, identity and intersectional considerations, including gender, sexuality, culture and religion, which interplay with psychosis and sexual health. Clinicians raised each of these priority areas, but emphasised risk prevention relative to patients’ more holistic view of their sexual health and well-being. Conclusions Women and non-binary people with early psychosis have wide-ranging sexual health priorities, affecting many facets of their lives. Clinical care should incorporate this knowledge to optimise sexual health and well-being in this population.
