A scoping review of parent-based barriers to parent–child communication about sexuality
Neelam Punjani
A * , Shannon D. Scott A , Amber Hussain A , Tammy Lu B , Farah Bandali B , Sheila McDonald B , Lisa Allen Scott B , Sonia Sultan C and Megan Kennedy A
A
B
C
Abstract
Parent–child communication about sexuality plays a critical role in promoting adolescents’ sexual and reproductive health, yet such discussions are limited across diverse cultural contexts. Despite the importance of comprehensive sexuality, parents frequently face barriers that hinder open and accurate dialogue. This scoping review aims to map the literature on parent-based barriers to sexuality communication with children and youth. It seeks to identify the barriers parents encounter and the socio-cultural dynamics that influence these interactions globally.
Following the Joanna Briggs Institute framework and PRISMA-ScR guidelines, a comprehensive literature search was conducted across 8 databases, yielding 59 peer-reviewed studies from 2000 to 2024. Eligible studies explored parent–child communication on sexuality, focused on barriers and employed qualitative, quantitative or mixed-methods designs.
Six key themes emerged as barriers: (1) parental discomfort and lack of confidence; (2) limited knowledge and educational gaps; (3) restrictive cultural and religious norms; (4) gendered expectations and communication disparities; (5) heteronormative assumptions excluding Two-Spirit, Lesbian, Gay, Bisexual, Transgender, Queer or Questioning, Intersex, Asexual (or Ally), plus other sexual and gender identities (2SLGBTQIA+) youth; and (6) concerns about judgment or misinterpretation. These barriers often stem from intergenerational silence, lack of training and societal stigma. Parents of children with disabilities or those identifying as gender-diverse faced additional challenges requiring tailored resources and clinical support.
Effective sexuality requires proactive, inclusive and culturally grounded parental engagement. Addressing structural and emotional barriers through tailored interventions, healthcare collaboration and educational toolkits is essential. This review underscores the need for future research, policy and health promotion efforts to support parent-based sexuality communication, especially for marginalized and under-resourced caregivers.
Keywords: barriers, communication, home-based, parent-child, scoping review, sexual health, sexuality, youth.
References
1 WHO. Sexual and reproductive health and research; 2025. Available at https://www.who.int/teams/sexual-and-reproductive-health-and-research/key-areas-of-work/sexual-health/defining-sexual-health [Retrieved 22 November]
2 Michielsen K, Ivanova O. Comprehensive sexuality: why is it important? 2022. Available at https://www.europarl.europa.eu/RegData/etudes/STUD/2022/719998/IPOL_STU(2022)719998_EN.pdf
3 Breuner CC, Mattson G, Committee on Adolescence, et al. Sexuality education for children and adolescents. Pediatrics 2016; 138(2): e20161348.
| Crossref | Google Scholar |
4 Mijatović D. Comprehensive sexuality education protects children and helps build a safer, inclusive society; 2020. Available at https://www.coe.int/ca/web/commissioner/-/comprehensive-sexuality-education-protects-children-and-helps-build-a-safer-inclusive-society [Retrieved 23 November]
5 UNESCO, United Nations Children’s Fund, Joint United Nations Programme on HIV/AIDS, United Nations Population Fund, World Health Organization, United Nations Entity for Gender Equality and the Empower of Women. Comprehensive sexuality education: advancing human rights, gender equality and improved sexual and reproduction health; 2021. Available at https://doi.org/10.54675/NFEK1277
6 CDC. Youth risk behavior survey: data sumary and trends report: 2007-2017; 2017. Available at https://www.cdc.gov/healthyyouth/data/yrbs/pdf/trendsreport.pdf
7 WHO. Sexually transmitted infections (STIs); 2025. Available at https://www.who.int/news-room/fact-sheets/detail/sexually-transmitted-infections-(stis) [Retrieved 2023]
8 Campbell JA, Walker RJ, Egede LE. Associations between adverse childhood experiences, high-risk behaviors, and morbidity in adulthood. Am J Prev Med 2016; 50(3): 344-352.
| Crossref | Google Scholar | PubMed |
9 OECD. Love & let live; 2020. Available at https://doi.org/10.1787/862636ab-en
10 Babel RA, Wang P, Alessi EJ, Raymond HF, Wei C. Stigma, HIV risk, and access to HIV prevention and treatment services among men who have sex with men (MSM) in the United States: a scoping review. AIDS Behav 2021; 25(11): 3574-3604.
| Crossref | Google Scholar | PubMed |
11 O’Farrell M, Corcoran P, Davoren MP. Examining LGBTI+ inclusive sexual health education from the perspective of both youth and facilitators: a systematic review. BMJ Open 2021; 11(9): e047856.
| Crossref | Google Scholar |
12 Saskatchewan Prevention Institute. Parents as sexual health educations for their children: a literature review; 2017. Available at https://skprevention.ca/resource-catalogue/sexual-health/parents-as-sexual-health-educators/
13 Widman L, Choukas-Bradley S, Noar SM, Nesi J, Garrett K. Parent-adolescent sexual communication and adolescent safer sex behavior: a meta-analysis. JAMA Pediatr 2016; 170(1): 52-61.
| Crossref | Google Scholar | PubMed |
14 Esan DT, Bayajidda KK. The perception of parents of high school students about adolescent sexual and reproductive needs in Nigeria: a qualitative study. Public Health Pract 2021; 2: 100080.
| Crossref | Google Scholar |
15 Ja NM, Tiffany JS. The challenges of becoming better sex educators for young people and the resources needed to get there: findings from focus groups with economically disadvantaged ethnic/racial minority parents. Health Educ Res 2018; 33(5): 402-415.
| Crossref | Google Scholar | PubMed |
16 Morrison-Beedy D, Ewart A, Ross S, Wegener R, Spitz A. Protecting their daughters with knowledge: understanding refugee parental consent for a U.S.-based teen sexual health program. Am J Sex Educ 2022; 17(4): 474-489.
| Crossref | Google Scholar |
17 Peters MDJ, Godfrey CM, Khalil H, McInerney P, Parker D, Soares CB. Guidance for conducting systematic scoping reviews. JBI Evid Implement 2015; 13(3): 141-146.
| Crossref | Google Scholar |
18 Bennett C, Harden J. Sexuality as taboo: using interpretative phenomenological analysis and a Foucauldian lens to explore fathers’ practices in talking to their children about puberty, relationships and reproduction. J Res Nurs 2019; 24(1-2): 22-33.
| Crossref | Google Scholar |
19 Bui TH. ‘Being a good girl’: mother-daughter sexual communication in contemporary Vietnam. Cult Health Sex 2020; 22(7): 794-807.
| Crossref | Google Scholar | PubMed |
20 Davis AC, Wright C, Curtis M, Hellard ME, Lim MSC, Temple-Smith MJ. ‘Not my child’: parenting, pornography, and views on education. J Fam Stud 2021; 27(4): 573-588.
| Crossref | Google Scholar |
21 Edwards LL, Hunt A, Cope-Barnes D, Hensel DJ, Ott MA. Parent-child sexual communication among middle school youth. J Pediatr 2018; 199: 260-262.
| Crossref | Google Scholar | PubMed |
22 Flores D, Docherty SL, Relf MV, McKinney RE, Barroso JV. “It’s almost like gay sex doesn’t exist”: parent-child sex communication according to gay, bisexual, and queer male adolescents. J Adolesc Res 2019; 34(5): 528-562.
| Crossref | Google Scholar | PubMed |
23 Gabbidon K, Shaw-Ridley M. Characterizing sexual health conversations among Afro-Caribbean families: adolescent and parent perspectives. J Adolesc Res 2019; 1-31.
| Crossref | Google Scholar |
24 Ganji J, Emamian MH, Maasoumi R, Keramat A, Khoei EM. Qualitative needs assessment: Iranian parents’ perspectives in sexuality education of their children. J Nurs Midwifery Sci 2018; 5(4): 140-146.
| Crossref | Google Scholar |
25 Grossman JM, Richer AM, Hernandez BF, Markham CM. Moving from needs assessment to intervention: fathers’ perspectives on their needs and support for talk with teens about sex. Int J Environ Res Public Health 2022; 19(6): 3315.
| Crossref | Google Scholar |
26 Guilamo-Ramos V, Bowman AS, Santa Maria D, Kabemba F, Geronimo Y. Addressing a critical gap in U.S. national teen pregnancy prevention programs: the acceptability and feasibility of father-based sexual and reproductive health interventions for latino adolescent males. J Adolesc Health 2018; 62(3s): S81-S86.
| Crossref | Google Scholar | PubMed |
27 Jimmyns CA, Meyer-Weitz A. “My child would never do that”: caregiver-child relationships regarding openness and communication about sexuality education in KwaZulu-Natal, South Africa. J HIV/AIDS Soc Serv 2019; 18(4): 382-398.
| Crossref | Google Scholar |
28 Kuborn S, Markham M, Astle S. “I wish they would have a class for parents about talking to their kids about sex”: college women’s parent–child sexual communication reflections and desires. Sex Res Soc Policy 2023; 20(1): 230-241.
| Crossref | Google Scholar |
29 Leija SG. Sexual socialization: a qualitative exploration of immigrant latina mothers’ perception of sex-communication with their adolescent daughters. Michigan State University, Human Development and Family Studies; 2022. Available at https://books.google.ca/books?id=KElozwEACAAJ
30 Livingston JA, Allen KP, Nickerson AB, O’Hern KA. Parental perspectives on sexual abuse prevention: barriers and challenges. J Child Fam Stud 2020; 29(12): 3317-3334.
| Crossref | Google Scholar |
31 Modise MA. Parent sex education beliefs in a rural South African setting. J Psychol Afr 2019; 29(1): 84-86.
| Crossref | Google Scholar |
32 Othman A, Shaheen A, Otoum M, et al. Parent-child communication about sexual and reproductive health: perspectives of Jordanian and Syrian parents. Sex Reprod Health Matters 2020; 28(1): 1758444.
| Crossref | Google Scholar |
33 Padilla-Walker LM. Longitudinal change in parent-adolescent communication about sexuality. J Adolesc Health 2018; 63(6): 753-758.
| Crossref | Google Scholar | PubMed |
34 Sandra Byers E, O’Sullivan LF, Mitra K, Sears HA. Parent-adolescent sexual communication in India: responses of middle class parents. J Fam Issues 2020; 42(4): 762-784.
| Crossref | Google Scholar |
35 Scull TM, Malik CV, Keefe EM. Determining the feasibility of an online, media mediation program for parents to improve parent-child sexual health communication. J Media Lit Educ 2020; 12(1): 13-25.
| Crossref | Google Scholar | PubMed |
36 Ustilaitė S, Petrauskienė A, Česnavičienė J. Self-assessment and expectations of mothers’ communication with adolescents on sexuality issues. Pedagogika 2023; 140(4): 116-133.
| Crossref | Google Scholar |
37 Grossman JM, Lynch AD, Richer AM, DeSouza LM, Ceder I. Extended-family talk about sex and teen sexual behavior. Int J Environ Res Public Health 2019; 16(3): 480.
| Crossref | Google Scholar |
38 Dagnachew Adam N, Demissie GD, Gelagay AA. Parent-adolescent communication on sexual and reproductive health issues and associated factors among preparatory and secondary school students of Dabat Town, Northwest Ethiopia. J Environ Public Health 2020; 2020: 4708091.
| Crossref | Google Scholar |
39 Eleuteri S, Aminoff D, Midrio P, Leva E, Morandi A, Spinoni M, Grano C. Talking about sexuality with your own child. The perspective of the parents of children born with arm. Pediatr Surg Int 2022; 38(12): 1665-1670.
| Crossref | Google Scholar | PubMed |
40 Feyissa M, Nigussie T, Mamo Y, Aferu T. Adolescent girl-mother communication on sexual and reproductive health issues among students in Fiche Town, Oromia, Central Ethiopia. J Prim Care Community Health 2020; 11: 2150132720940511.
| Crossref | Google Scholar |
41 Guilamo-Ramos V, Thimm-Kaiser M, Benzekri A, Rodriguez C, Fuller TR, Warner L, Koumans EHA. Father-son communication about consistent and correct condom use. Pediatrics 2019; 143(1): e20181609.
| Crossref | Google Scholar |
42 Indraswari R, Shaluhiyah Z, Widjanarko B, Suryoputro A. Factors of mothers’ hesitation in discussing reproductive health. Int J Public Health Sci 2021; 10: 801-806.
| Crossref | Google Scholar |
43 Katahoire AR, Banura C, Muhwezi WW, Bastien S, Wubs A, Klepp K-I, Aarø LE. Effects of a school-based intervention on frequency and quality of adolescent-parent/caregiver sexuality communication: results from a randomized-controlled trial in Uganda. AIDS Behav 2019; 23(1): 91-104.
| Crossref | Google Scholar | PubMed |
44 Orcasita Pineda LT, Cuenca Morales J, Montenegro Céspedes JL, Garrido Rios D, Haderlein A. Dialog and knowledge about sexuality of parents of adolescent school children. Rev Colomb Psicol 2018; 27(1): 41-53.
| Crossref | Google Scholar |
45 Malango NT, Hegena TY, Assefa NA. Parent-adolescent discussion on sexual and reproductive health issues and its associated factors among parents in Sawla town, Gofa zone, Ethiopia. Reprod Health 2022; 19(1): 108.
| Crossref | Google Scholar |
46 Mavhandu-Mudzusi AH, Mhlongo BG. Adolescents’ sexual education: parental involvement in a rural area in Kwazulu-Natal, South Africa. Afr J Nurs Midwifery 2021; 23(1): 1-15.
| Crossref | Google Scholar |
47 Mihretie GN, Muche Liyeh T, Ayalew Goshu Y, Gebrehana Belay H, Abe Tasew H, Belay Ayalew A. Young-parent communication on sexual and reproductive health issues among young female night students in Amhara region, Ethiopia: community-based cross-sectional study. PLoS ONE 2021; 16(6): e0253271.
| Crossref | Google Scholar |
48 Nurachmah E, Afiyanti Y, Yona S, et al. Mother-daugther communication about sexual and reproductive health issues in Singkawang, West Kalimantan, Indonesia. Enferm Clin 2018; 28: 172-175.
| Crossref | Google Scholar |
49 Sanghirun K, Fongkaew W, Viseskul N, Lirtmunlikaporn S. Perspectives of parents regarding sexual and reproductive health in early adolescents: a qualitative descriptive study. Pac Rim Int J Nurs Res 2021; 25(1): 60-74.
| Google Scholar |
50 Serrano J, Crouch JM, Albertson K, Ahrens KR. Stakeholder perceptions of barriers and facilitators to sexual health discussions between foster and kinship caregivers and youth in foster care: a qualitative study. Child Youth Serv Rev 2018; 88: 434-440.
| Crossref | Google Scholar |
51 Simmonds JE, Parry CDH, Abdullah F, Burnhams NH, Christofides N. “Knowledge I seek because culture doesn’t work anymore … It doesn’t work, death comes”: the experiences of third-generation female caregivers (gogos) in South Africa discussing sex, sexuality and HIV and AIDS with children in their care. BMC Public Health 2021; 21(1): 470.
| Crossref | Google Scholar |
52 Teppasom W, Chamroonsawasdi K, Nunthamongkolchai S, Kittipichai W, Lapvongwatana P. Challenges and obstacles of mother-daughter sexual communication among Thai rural communities: an exploratory study. J Public Hlth Dev 2021; 19(2): 28-46.
| Google Scholar |
53 Abboud S, Flores DD, Bond K, Chebli P, Brawner BM, Sommers MS. Family sex communication among Arab American young adults: a mixed-methods study. J Fam Nurs 2022; 28(2): 115-128.
| Crossref | Google Scholar | PubMed |
54 Agbemenu K, Hannan M, Kitutu J, Terry MA, Doswell W. “Sex will make your fingers grow thin and then you die”: the interplay of culture, myths, and taboos on African immigrant mothers’ perceptions of reproductive health education with their daughters aged 10-14 years. J Immigr Minor Health 2018; 20(3): 697-704.
| Crossref | Google Scholar | PubMed |
55 Depauli C, Plaute W. Parents’ and teachers’ attitudes, objections and expectations towards sexuality education in primary schools in Austria. Sex Educ 2018; 18(5): 511-526.
| Crossref | Google Scholar |
56 Gabster A, Cislaghi B, Pascale JM, Francis SC, Socha E, Mayaud P. Sexual and reproductive health education and learning among Indigenous youth of the Comarca Ngäbe-Buglé, Panama. Sex Educ 2022; 22(3): 260-274.
| Crossref | Google Scholar |
58 Liu T, Fuller J, Hutton A, Grant J. Congruity and divergence in perceptions of adolescent romantic experience between Chinese parents and adolescents. J Adolesc Res 2018; 35(4): 546-576.
| Crossref | Google Scholar |
59 Nadeem A, Cheema MK, Zameer S. Perceptions of Muslim parents and teachers towards sex education in Pakistan. Sex Educ 2021; 21(1): 106-118.
| Crossref | Google Scholar |
60 Othman A, Abuidhail J, Shaheen A, Langer A, Gausman J. Parents’ perspectives towards sexual and reproductive health and rights education among adolescents in Jordan: content, timing and preferred sources of information. Sex Educ 2022; 22(5): 628-639.
| Crossref | Google Scholar |
61 Pichon M, Howard-Merrill L, Wamoyi J, Buller AM, Kyegombe N. A qualitative study exploring parent-daughter approaches for communicating about sex and transactional sex in Central Uganda: implications for comprehensive sexuality education interventions. J Adolesc 2022; 94(6): 880-891.
| Crossref | Google Scholar | PubMed |
62 Rahnavardi M, Bostani Khalesi Z, Rezaie-Chamani S. Parents’ and experts’ views on the sexual health education of adolescent girls: a qualitative study. Sex Relationsh Ther 2024; 39: 1145-1157.
| Crossref | Google Scholar |
63 Ramchandani K, Morrison P, Gold MA, Akers AY. Messages about abstinence, delaying sexual debut and sexual decision-making in conversations between mothers and young adolescents. J Pediatr Adolesc Gynecol 2018; 31(2): 107-115.
| Crossref | Google Scholar | PubMed |
64 Smollin L, Valles JCG, Torres MI, Granberry PJ. Puerto Rican mothers’ conversations about sexual health with non-heterosexual youth. Cent J 2018; 30(2): 406-428.
| Google Scholar |
65 Thomas K, Patterson K, Nash R, Swabey K. What have dads got to do with it? Australian fathers’ perspectives on communicating with their young children about relationships and sexuality. Sex Educ 2022; 22(2): 169-183.
| Crossref | Google Scholar |
66 Vujcich D, Lyford M, Bellottie C, Bessarab D, Thompson S. Yarning quiet ways: Aboriginal carers’ views on talking to youth about sexuality and relationships. Health Promot J Aust 2018; 29(1): 39-45.
| Crossref | Google Scholar |
67 DeSouza LM, Grossman JM, Lynch AD, Richer AM. Profiles of adolescent communication with parents and extended family about sex. Fam Relat 2022; 71(3): 1286-1303.
| Crossref | Google Scholar |
68 Dolev-Cohen M, Ricon T. Talking about sexting: association between parental factors and quality of communication about sexting with adolescent children in Jewish and Arab Society in Israel. J Sex Marital Ther 2022; 48(5): 429-443.
| Crossref | Google Scholar | PubMed |
69 Elegbe O. Sexual communication: a qualitative study of parents and adolescent girls discussion about sex. J Health Manag 2018; 20(4): 439-452.
| Crossref | Google Scholar |
70 Evans R, Widman L, Kamke K, Stewart JL. Gender differences in parents’ communication with their adolescent children about sexual risk and sex-positive topics. J Sex Res 2020; 57(2): 177-188.
| Crossref | Google Scholar | PubMed |
71 Overbeek G, van de Bongardt D, Baams L. Buffer or brake? The role of sexuality-specific parenting in adolescents’ sexualized media consumption and sexual development. J Youth Adolesc 2018; 47(7): 1427-1439.
| Crossref | Google Scholar | PubMed |
72 Flores DD, Greene MZ, Taggart T. Parent-child sex communication prompts, approaches, reactions, and functions according to gay, bisexual, and queer sons. Int J Environ Res Public Health 2021; 19(1): 74.
| Crossref | Google Scholar |
73 Rubinsky V, Cooke-Jackson A. “It would be nice to know I’m allowed to exist:” designing ideal familial adolescent messages for LGBTQ women’s sexual health. Am J Sex Educ 2021; 16(2): 221-237.
| Crossref | Google Scholar |
74 Isaksen KJ, Musonda P, Sandøy IF. Parent-child communication about sexual issues in Zambia: a cross sectional study of adolescent girls and their parents. BMC Public Health 2020; 20(1): 1120.
| Crossref | Google Scholar |
75 Muhwezi WW, Katahoire AR, Banura C, et al. Perceptions and experiences of adolescents, parents and school administrators regarding adolescent-parent communication on sexual and reproductive health issues in urban and rural Uganda. Reprod Health 2015; 12(1): 110.
| Crossref | Google Scholar |
76 Wamoyi J, Fenwick A, Urassa M, Zaba B, Stones W. Parent-child communication about sexual and reproductive health in rural Tanzania: implications for young people’s sexual health interventions. Reprod Health 2010; 7: 6.
| Crossref | Google Scholar |
77 Kee-Jiar Y, Shih-Hui L. A systematic review of parental attitude and preferences towards implementation of sexuality education. Int J Eval Res Educ 2020; 9(4): 971-978.
| Crossref | Google Scholar |
78 Merghati-Khoei E, Abolghasemi N, Smith TG. “Children are sexually innocent”: Iranian parents’ understanding of children’s sexuality. Arch Sex Behav 2014; 43(3): 587-595.
| Crossref | Google Scholar | PubMed |
79 Babayanzad Ahari S, Behboodi Moghadam Z, Azin SA, et al. Concerns and educational needs of Iranian parents regarding the sexual health of their male adolescents: a qualitative study. Reprod Health 2020; 17(1): 24.
| Crossref | Google Scholar |
80 Ashcraft AM, Murray PJ. Talking to parents about adolescent sexuality. Pediatr Clin North Am 2017; 64(2): 305-320.
| Crossref | Google Scholar | PubMed |
81 Kamaludin NN, Muhamad R, Mat Yudin Z, Zakaria R. Barriers and concerns in providing sex education among children with intellectual disabilities: experiences from Malay mothers. Int J Environ Res Public Health 2022; 19(3): 1070.
| Crossref | Google Scholar |
82 André TG, Valdez-Montero C, Márquez-Vega MA, et al. Communication on sexuality between parents and adolescents with autism spectrum disorder: a systematic review. Sex Disabil 2020; 38(4): 217-229.
| Crossref | Google Scholar |
83 Bastien S, Kajula LJ, Muhwezi WW. A review of studies of parent-child communication about sexuality and HIV/AIDS in sub-Saharan Africa. Reprod Health 2011; 8(1): 25.
| Crossref | Google Scholar |
84 Fernández L, Alvarez-Cueva P, Masanet MJ.. From sexting to sexpreading: trivialization of digital violence, gender differences and collective responsibilities. Sex & Cult 2025; 29(3): 1121-1153.
| Crossref | Google Scholar |
85 McKay EA, Fontenot HB. Parent-adolescent sex communication with sexual and gender minority youth: an integrated review. J Pediatr Health Care 2020; 34(6): e37-e48.
| Crossref | Google Scholar |
86 UNESCO. International technical guidance on sexuality education: an evidence-informed approach; 2018. Available at https://www.who.int/publications/m/item/9789231002595
