Our findings reinforce existing evidence suggesting that asset-based services can address the risks and realities of negative sexual health consequences in pragmatic and non-judgmental ways that do not perpetuate shame or fear. When this happens, people are more likely to seek out services, to reduce their risk of harmful outcomes, and to experience their sexuality and relationships in positive ways. Services must be welcoming, inclusive, well-informed and confidential for all – especially for unmarried and LGBTQI+ young adults. 

In practice, high-quality SRHR Services with a Smile can encompass the following. 

• Services are underpinned by laws that ensure universal access to SRH information and health care. 
• Sexual pleasure is embedded in sexual health interventions. 
• Every young person and adult in a community has access to SRHR services. The notion of ‘access’ should take into consideration diverse factors including costs (financial and opportunity costs), the distance service users must travel, the attitudes and behaviour of service providers towards clients (especially marginalized groups), privacy and confidentiality, and eligibility requirements for services or supplies. 
• SRHR service provision is supported by existing health system structures aimed at ensuring quality-of-care. 
• SRHR services have functioning referral networks in place for specialist services. 
• Personnel are well trained and supported to provide inclusive, confidential, accessible, sex-positive and gender transformative care.

In this activity, participants explore ideal SRHR services that are inclusive, affirming, pleasure-positive and gender-transformative, and then reflect on actionable steps to move toward these ideals. 

Time: 1 hour 

Materials: 

• Flipchart 
• Marker pens  
• Notepaper or drawing paper and pens for all participants 

Step 1 Imagine yourself in different situations and dream freely 

Divide participants into three groups. Assign each group a scenario (each group gets a different one):  

• as they were young and 20 years in the future 
• with a disability or another health condition they might be reluctant to discuss 
• as LGBTQI+ or another identity that is typically hidden, marginalized, or stigmatized in that community 

Ask participants to close their eyes and picture themselves in these scenarios. 

Encourage them to think freely and creatively about what SRHR services would make them smile in each scenario. Emphasize that they don’t need to worry about feasibility, resources or other current limitations. They can dream freely. 

On notepaper / drawing paper / flipchart paper, each group lists or draws the features of the ideal SRHR services in their particular scenario. 

Step 2: Share and discuss 

Each group shared their discussions in plenary. 

Take note of common themes, innovative ideas and surprising suggestions and encourage discussion among participants about these. 

Step 3: Reality check 

Now ask participants to reflect on the following: 

• Which ideas could realistically be implemented? 
• What is already being done in their programme/project? 
• Where are the gaps between the ideal and current reality? 

Step 4: Prioritize actions  

Back in the groups, ask them to identify 2–3 concrete actions to bring services closer to their “smile-worthy” ideal. 

Record these and discuss potential next steps or responsibilities. 

Optional variation 

Role-play: participants act as different service users to explore how current services meet – or fail to meet – the ideals identified.