Including “sexual” in sexual and reproductive health labor: Gendered experiences of sexually transmitted infection (STI) prevention, testing, and treatment among young people in Texas

Sexually transmitted infections (STIs) in the U.S. have been persistently high for over a decade, and they disproportionately burden young people. Yet limited qualitative research has explored how young people understand, navigate, and experience STIs amid this ongoing epidemic. Drawing on in-depth interviews with 33 young people (ages 15–25) across Texas, this study examines the gendered dynamics of STI prevention, testing, and treatment through a reproductive labor framework. Findings reveal adolescent girls and young women assume the majority of sexual health labor: managing prevention, initiating testing, and coping with the emotional and relational consequences of infection. This unequal distribution of labor appears linked to the greater salience of STIs for adolescent girls and young women, as the sexual double standard renders testing positive more consequential for them than for adolescent boys and young men. At the same time, young men's limited engagement in STI prevention reflects broader structural neglect: sex education and reproductive health policy in the U.S. have long centered on pregnancy prevention and excluded young men. As a result, young people of all genders are poorly equipped to engage in proactive, communicative approaches to STI prevention. By extending the concept of reproductive labor beyond fertility and contraception to encompass STI-related care, this study highlights how gendered and heteronormative systems of education and policy produce unequal sexual health responsibilities. Comprehensive, inclusive sex education that reframes STI prevention as shared sexual health work can help redistribute this labor and reduce STI burden among young people.