Young people’s sexual wellbeing: a systematic review of qualitative studies

Background Young people’s adverse sexual experiences contribute to a significant global mental health burden and detract from their quality of life. Sexual wellbeing connects sexual and mental health and can offer a novel perspective on drivers and impacts of young people’s sexual behaviour. It is a promising means through which to shift public health focus from risk to aspects of sex relevant to broader wellbeing. Methods This systematic review aimed to characterise sexual wellbeing for adolescents and emerging adults (aged 16–24 years). We searched four databases for peer-reviewed qualitative literature on young people’s accounts relevant to sexual wellbeing published between 1988 and 2025. We intensity sampled and thematically synthesised studies against Mitchell et al ’s Sexual Wellbeing Conceptual Framework. PROSPERO registration: CRD42022315593. Results We thematically synthesised 93 papers, representing 3152 participants across 25 countries. Our synthesis characterises youth sexual wellbeing as feeling: congruence between one’s sexual thoughts, feelings, values, behaviours and emerging identities; driven by curiosity or desire; capable of advocating for one’s wants and boundaries; able to authentically express oneself; deserving of care, respect and support; and expectant of a positive sexual future. Women, sexual and gender minorities, sexual violence survivors, youth with disabilities or health conditions, and those in deprived or sexually conservative communities report additional barriers to wellbeing. Conclusions This first-ever review of youth sexual wellbeing underscores its significance during this life stage, and outlines similarities and differences compared with adults. The findings demand a stronger focus on young people’s priorities for sexual wellbeing to support their healthy development.