Sexual Health Questions? We’re Asking for a Friend
Katy Ashe, Design Director, YLabs
Mialissa Flores, Youth Advisory Board Member, Asking for a Friend
“Google always comes up with 'you probably have chlamydia’,” says 17-year-old *Paige. “...most of our sex ed is just from experience.”
But as San Francisco-based Paige says, chlamydia can’t always be the answer. The only problem: Paige, like too many young people aged 14-19 in California and across the U.S., simply doesn't know how to get the answers she needs.
In the U.S, three in five young people have sex before age 16. And while states, like California, have laws mandating comprehensive sex education, two in five high schools and one in five middle schools nationwide provide sex ed. But even when offered, information gaps remain. In California, only three in 20 students report receiving sexual health education that provides LGBTQ+ inclusive information; one in five students say their school offers HIV/AIDS prevention education.
All of this adds up to a completely preventable and unnecessarily high stakes environment for young people like Paige in need of answers. We can, we must do better.
At YLabs, a global design and youth-centered research organization, we’ve worked with young people to co-create online sex ed platforms for youth. For example, we co-created CyberRwanda with young people, which supports youth through every step of their reproductive health journey and includes edutainment webcomics, animated videos, an advice column, a pharmacy locator, and a robust FAQ library - serving as a one-stop-shop for young people's sexual health curiosities and needs.
With threats to sexual health for everyone in the U.S., but especially young people, we decided to adapt our experience in Rwanda to the states, beginning in California.
But how? I’m Asking for a Friend.
Why California?
From the start, we wondered if California was the right place to kick off the work. With the plethora of resources already available, especially in a state rich with sexual and reproductive health programming and supportive policy, did young people even need an online sex ed platform?
In short: yes.
Our research shows: there are youth-tailored, and state-by-state reproductive health programs. They’re just really hard to find, often inaccessible for teenagers, and designed without young people’s input.
That’s how the YLabs-led and youth co-created Asking for a Friend came to be.
Introducing Asking for a Friend
We spoke with 270+ young people in California and worked with them to co-design Asking for a Friend from idea to what we are launching today. What did these young people have to say?:
1. Where is the diversity?
Gen Z (currently aged 12-27) is the most racially diverse youth generation in U.S. history and more than one in four Gen Z adults identify as a member of the LGBTQ+ community. Among our youth co-creators, 94% identified as youth of color, 57% as LGBTQ+, and 16% as non-binary. As they said, most current sexual health resources are not designed for the needs of their extremely diverse youth population, often leaving behind youth that are gender diverse, queer, non-native English speakers, low-income, or historically disenfranchised by the medical community, such as BIPOC, foster youth (where nearly one in two teen girls in foster care will get pregnant by age 19, compared to three in 10 teen girls more broadly), and youth in juvenile hall, on probation, house arrest, in group homes and other residential facilities. These populations face disproportionately poor sexual health outcomes, which for many can be life altering.
2. “Speak to me like an adult - but start at the beginning”
…is something we hear from young people, again and again. Existing resources are not tailored to young people’s needs or beginner-level understanding, so youth are forced to cross-reference resources, which can be overwhelming, inconclusive, and panic-inducing. Meanwhile, resources that are tailored toward teens can often feel too childish and fail to speak to them in a manner that acknowledges that they are likely sexually active and arriving at the information with varied experiences, emphasizing the importance of being trauma informed.
3. Privacy is everything
Young people need to be assured of services’ confidentiality, from accessing information online to accessing the care they need. Fear of parents finding out is the largest barrier to accessing sexual health services and makes the entire experience feel incredibly high stakes. Even in scenarios where young people felt their parents were likely to be supportive, they want the agency and privacy to make these choices for themselves.
4. Payment is a barrier
As a young person, this would likely be their first foray into the healthcare system by themselves. Young people – who often only have access to cash or PayPal – are often unable to pay for the services they need and/or are unaware that there may be free or low-cost services available to them. Fear of the complexity of health insurance looms over young people and they worry that any services rendered will leave a paper trail leading back to their parents or guardians. There are a plethora of programs and services available in California, but they are difficult to find and navigate. Young people are finding workarounds - like ordering morning after pills on DoorDash or paying cash to a peer who is selling it out of their backpack - but this doesn’t have to be their only option.
In response, Asking for a Friend offers:
Decision-making tools that support young people to navigate through, and get answers to, their most pressing sexual health concerns. The tool includes interactive quizzes such as “Which birth control is my best match?”, “Should I get an STI test?”, “Is my relationship healthy?” and “Is abortion right for me?” that walk young people through the steps of making their own complex decisions and providing them with research backed information along the way. The results point them to free resources in their community and programs that they are eligible for; such as free STI testing sites; safe abortion services, and includes young people’s legal rights in a post-Roe landscape.
Linkages to youth-friendly reproductive healthcare at local low-cost clinics and service providers with an emphasis on free programming. AFAF integrates datasets from several programs that provide free services across all of California; such as Family Pact’s network of 7K+ providers that provide free, anonymous sexual health services for young people; PrEP-AP, which provides free HIV prevention services in the state, and many more.
FAQs that demystify taboo topics and center young people’s agency. The FAQ accounts for intersectional identities, with a focus on queer youth and youth of color; normalizes and celebrates sexuality and gender identity; and elevates the hard questions. We answered the questions that we got from the 270+ young people that informed the design of the entire platform.
"AFAF is the personalized reproductive health decision-making tool I wish I could put in the hands of every one of my young patients who are sexually active and could get pregnant,” says Dr. Jessie Liu, MD, a family medicine physician at the Oakland-based La Clinica de la Raza. “It's practical and actionable. It's accessible and private.”
This is YLabs’ Wheelhouse
We modeled AFAF’s design and development after YLab’s CyberRwanda, a Rwanda-based reproductive health digital platform co-created with Rwandan youth.
Like in California, young Rwandans:
Don’t feel informed enough to know what reproductive health products to choose. They want a provider to support their decision making process and information about what community-based health facilities they can go to.
Frequently experience a need during a sexual health crisis, but lack the clear guidance and directive information to resolve their issue. Young people desire to turn to CyberRwanda in these times to guide them with supportive solutions.
Fear their parents discovering their crisis, as it may anger or disappoint them, which shrinks their adult support network and leads them to see information from unreliable sources.
Have limited exposure to sexual health products and want an immersive introduction that shows them what to expect.
CyberRwanda responds, and it works. Since 2021, CyberRwanda has reached 25K+ young people across Rwanda. Users report increased HIV testing rates (from 38% in 2021 to 49% in 2023) and reproductive health product knowledge, like emergency contraception (from 34% in 2021 to 55% in 2023).
AFAF is Built for U.S. Scale. We Can Get There, Together.
With AFAF’s California pilot, which launched in May 2024, we aim to reach the 42M+ young people nationwide by 2027. But to scale AFAF, we have big questions to explore:
What partnerships do we need to reach the hardest to reach young people?
How can we reach young people in more rural and legally restricted states?
What partnerships will enable youth-friendly telehealth integration?
How can we expand the database to help young people pay for services they otherwise couldn't afford out of pocket?
“Decisions around when or if to have a child are life-changing, and tools such as AFAF are vital to ensuring everyone, everywhere can act on what is best for them,” says Liu. “AFAF democratizes reproductive health knowledge by transcending the widespread political, racial, and religious barriers that too many youth face in accessing fact-based information-- which is critically and increasingly important in these post-Roe times."
With AFAF, Paige – like young people across California – can feel confident accessing trusted, reliable reproductive health information, all at her fingertips. And it’s finally confirmed: not every answer is, in fact, chlamydia.
Together, we can take this work further. Will you join us? I’m Asking for a Friend.
If you are interested in exploring the AFAF platform, explore here.
If you are interested in getting involved, please reach out to @askingforafriend@ylabsglobal.org
AFAF is generously funded by the Lefkofsky Family Foundation; Los Angeles County Abortion Access Safe Haven Pilot Program; and California Wellness Foundation. AFAF was developed in partnership with physicians and researchers on our expert advisory board that work in clinics and programs that serve low-income, and gender diverse youth populations.