Trust, autonomy, and informed consent: a qualitative investigation of youth experiences accessing contraception in...

We sought to understand, "What are the contraception access experiences, beliefs, attitudes, knowledge and needs of youth in Canada, from the perspectives of youth and youth service providers?" We explore person-centred contraception care and highlight the importance of fostering trust, autonomy, and informed consent. We conducted one-on-one semi-structured interviews with youth (aged 15-25) and healthcare providers (HCPs) across Canada, representing a diversity of rural and urban settings, gender, age, and ethnicities. Using social constructivist grounded theory, we identified key themes related to reproductive autonomy, trust, and informed consent. We analysed data from 79 youth and 27 HCPs, identifying five themes: (1) Valuing shared decision making; (2) "Pushing" contraception: putting a stop to paternalism; (3) Seeking anti-oppressive care; (4) Contraception care is all about trust; (5) Practising control over my own body. Participants valued shared decision-making and wanted to feel that "we're in this together". Both youth and HCP participants shared stories of HCPs "pushing contraception" on youth and experiences of medical discrimination which impeded feelings of safety and autonomy. In response, youth advocated for anti-oppressive care and identified the importance of "therapeutic relationship building," emphasising that fostering safety with HCPs is "all about trust." Finally, youth reported practising advocating for their reproductive autonomy to have control over their own body. Our research highlights the importance of shared decision-making, informed consent, and anti-oppressive care in fostering supportive and safe contraception access for youth. Results have implications for jurisdictions where youth face increasing barriers to contraception access. DOI: 10.1080/26410397.2026.2678063.