Sexpress: Toronto Teen Survey Final Report

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By: Sarah Flicker, Susan Flynn, June Larkin, Robb Travers, Adrian Guta, Jason Pole, & Crystal Layne
Org: Planned Parenthood Toronto
Date: 2009

What are diverse Toronto teens saying about HIV, sexual health and the services they want?

The goal of the Toronto Teen Survey (TTS) is to conduct research that will enrich both the quality and quantity of sexual health information available to Toronto teens and improve the ways in which sexual health promotion and care are delivered. Specific objectives are to:

  • explore the sexual health services youth seek out in Toronto
  • discover the access barriers youth face in seeking services
  • learn where youth are getting their sexual health information
  • ascertain what youth want and need in terms of sexual health information
  • understand where youth want to get that information and in what formats
  • investigate the similarities and differences between the needs of diverse youth communities

Examining how youth feel about services is an important first step in determining how services could be improved and made more accessible. Research findings will help to illuminate and enhance our understanding of exactly how specific groups of youth perceive sexual health services and how they will respond to innovative programming and service delivery.


This study comes out of some key realities regarding youth and sexual health and sexual health information:

  • Youth have a right to sexual health services that meet their needs.
  • Sexually Transmitted Infections among youth are on the rise.
  • Youth sexual health knowledge has declined.
  • Early intervention is important for healthy sexual development.
  • Sexual health services should meet the needs of diverse youth.
  • There is a global movement towards more inclusionary models of sexual health promotion.
  • Peer-based participatory research approaches work.

This is the largest and most diverse community-based sample undertaken in Canada to investigate sexual health service barriers for youth. The researchers made a concerted and specific effort to reach out to diverse youth (broadly defined), resulting in a sample of 1,216 youth surveys from youth across the city, with the following demographics:

  • 54% identified as female, 45% as male
  • 1% also identified as trans or other or both
  • 85% of our sample self-identified as racialized youth (39% Black (African/Canadian/Caribbean), 25% Asian (East/South), 15% White (Canadian/European), 13% Multiracial, 6% Other (Latin American/Middle Eastern, etc.)
  • 33% were born outside Canada
  • 17% reported a physical or cognitive disability or addiction
  • 4% identified as lesbian, gay, bisexual, two-spirited, pan-sexual or queer (herein after referred to as ‘sexually diverse’); 3% identified as questioning their sexuality
  • 6% lived in foster/group homes; 8% lived independently
  • Youth participants came from across the city, with high representation of youth living in under served neighbourhoods

As well, researchers met with 80 participants representing 55 agencies who participated in their service provider focus groups. Of the people they heard from:

  • 53% were front line staff, 16% were managers
  • 54% worked for health clinics, 19% worked in summer camps, and 41% worked in youth drop-ins
  • 28% worked in agencies that had hosted TTS survey sessions

Research "Limitations"

From the report: "Given that potential participants were selected from pre-existing youth groups, youth were not randomly sampled. Adolescents between 13 to 17 years old were targeted, however, if some members of the youth group were older than 17, they were not precluded from participating. An effort was made to over-sample racialized, sexually diverse and other groups of youth who are often ‘unheard.’ Care must therefore be taken not to over generalized findings to all Toronto youth. Further, racial categorizations used in this report, such as "Black" and "Asian" are somewhat over-inclusive and don’t reflect the richness and complexity within each group. Another limitation is that the survey required a fair degree of English literacy. Translators and other types of assistance were made available in some sessions where need was identified. Finally, data were collected in Toronto and may not be generalizable to other settings."

It's fair to say that these limitations may be considered strengths in our sector, as typically marginalized and under-represented youth are well represented in this survey and report.

Watch this video (runs 35 minutes) about their process, answering the questions:

  • How was the survey created?
  • What was the role of youth?
  • What did we learn from the process?

SexPress: Toronto Teen Survey Movie from PPT Teen Program on Vimeo.


  • Toronto teens are sexually active in a variety of ways.
  • Most teens have never accessed clinical sexual health care. Youth less likely to visit sexual health services:
    • male
    • Asian
    • younger
    • Aboriginal
    • Black
    • Muslim

Youth accessing sexual health services are generally unhappy with their care.

  • Eight percent of youth are not getting any sexual health education.
  • There is a disconnect between what youth are learning and what they want to know.
  • Service providers face many barriers to providing adequate sexual health care.
  • The extent to which youth access and benefit from sexual health services varies by age, gender, race, cultural heritage, sexual orientation and length of time in Canada.

70 targetted recommendations were made in 4 areas:

  • clinical care
  • school-based sexual health education
  • Toronto Public Health
  • community based organizations

Further analyses of population specific data will be released in 2009-2010, including:

  • The Sexual Health needs of Youth New to Canada
  • The Sexual Health needs of African, Caribbean and other Black youth
  • The Sexual Health needs of South Asian youth
  • and more

Downloads (in PDF format)