Let’s Talk about It

Providing sexual and reproductive health information

May 1, 2023

The Library's Guide to Sexual and Reproductive Health Information, Barbara A. Alvarez
Illustration: ©Alina.Alina/Adobe Stock

When I have connected with public librarians about sharing sexual and reproductive health (SRH) information, a common refrain has been that patrons do not come to the reference desk for this information. This isn’t surprising. How comfortable would you be going up to a stranger and asking them a question about your health, much less your sexual health? Of course, it is a mistake to attribute a lack of questions to a lack of interest. Many people may be afraid to ask, or they may assume the library doesn’t have this information.

Fears and biases

Let’s first discuss library anxiety. I see this firsthand in my own work as a reference services instructor. One of the assignments I task students with is to ask a reference librarian a real reference question and reflect on their experience. Many students report back that they were worried their questions were silly or that they were needlessly disturbing the librarian.

Keep in mind that these are graduate students in library and information science who have, at minimum, a basic understanding of library services. If they feel anxiety approaching the reference desk, imagine how someone else must feel. Now add a layer of asking a personal, health-related question—one that is perhaps enveloped in stigma and shame. Is it any surprise people aren’t approaching our desks and openly asking about contraception, pregnancy, and sexuality?

The Library's Guide to Sexual and Reproductive Health Information, Barbara A. Alvarez
This is an excerpt from The Library’s Guide to Sexual and Reproductive Health Information by Barbara A. Alvarez (ALA Editions, February).

The lack of diversity in libraries undoubtedly also plays a role in patrons’ fears of approaching the reference desk. According to the ALA membership survey from 2019, 87.9% of respondents identified as white; only 4.9% of members reported their ethnicity as Hispanic or Latino; 4.2% said they are Black or African American; and 2.2% reported being multiracial.

Given the homogeneity of the library profession, biases are bound to proliferate. These biases certainly do not bode well for providing comprehensive SRH information to those who may belong to a different race or ethnicity, as biases can manifest as stereotypes held against groups of people and can be both conscious and unconscious.

While we may genuinely want to make our public libraries more reflective of the communities we serve and to make them welcoming and open spaces, our biases may prevent us from recognizing gaps in services, staffing, collections, and resources—including SRH information.

Therefore, providing adequate sexual and reproductive health information and services isn’t just about buying more books or hosting more programs. To build an inclusive environment where people can receive comprehensive SRH information, we librarians must do inner identity work to approach these important topics thoughtfully.

Privacy and confidentiality

Another important concern for library users is privacy. When providing reference services for health information, we should ensure patron privacy and confidentiality.

As with any other reference desk question, librarians should adhere to the guidelines provided by the Reference and User Services Association (RUSA). These service guidelines include visibility and approachability, showing interest in patrons’ needs, active listening, asking clarifying questions, searching, and following up.

RUSA also outlines how to provide a quality reference interview. Notably, sections 3.1.9 and 3.1.10 of the service guidelines state that a library worker “maintains objectivity; does not interject value judgments about the subject matter or the nature of the question into the transaction; respects patron privacy; and maintains confidentiality after the transaction.”

By providing SRH information, you are by no means expected to be an expert on this topic. However, as with the myriad other topical questions that patrons ask public librarians daily, we are expected to direct people to information and resources.

Special care should be taken with SRH reference questions. You may want to move the interaction to a more private space within the library and offer information in a variety of formats depending on the patron’s information needs and abilities. In all cases, you should refrain from making assumptions and judgments about the question and check that the patron feels satisfied with the information received.

Librarians should never interpret medical information, make direct or indirect diagnoses, recommend health care procedures or practices, or refer patrons to specific health care providers. Libraries should consider posting both digital and printed disclaimers that explain how reference interactions are not a substitute for working with a health care provider or professional. And with the changing legal landscape surrounding topics like contraception, abortion, and LGBTQIA+ health issues, librarians should also ensure that they are not providing legal advice.

Libraries should also look into incorporating chat, text, and email platforms for people with accessibility or privacy concerns. Self-checkout machines and contactless pickups can offer a degree of confidentiality. Furthermore, remind patrons that public libraries do not keep records of materials checked out, nor will libraries disclose this information to others.

Curating content

Perhaps one of the most useful skills you can take on for your library community—and for SRH issues in particular—is to get into the habit of curating content for your patrons. Content creation efforts like resource guides and tutorials can empower people to use the library’s available resources.

Resource guides and LibGuides are two popular creation methods. A resource guide is a collection of resources on a specific topic. It can direct patrons to databases, books, and relevant library programs and events.

A resource guide can also include information about how people can search the catalog or databases using specific keywords, filters, and subject headings. Free design tools like Canva can help librarians create attractive resource guides that they can print and share at the reference desk and link to on the library’s website.

LibGuides are content management systems that librarians use to curate content and information on specific topics. They use widgets and other electronic tools to make them accessible and shareable on library websites and are most commonly used at university libraries.

Whether you create a resource guide or use LibGuides, I recommend linking the resource in a place that is highly visible. For example, it may be helpful to have a link to different guides at the top of a database page.

Video tutorials

Video tutorials can provide guidance to people who may otherwise be too afraid to go to the reference desk and ask for information.

Where the resource guide provides a general overview about what information is available, a tutorial dives deeper into specific library resources. For example, a tutorial can be created to instruct people how to search for sensitive topics in the library catalog or databases. Another tutorial could include information about how people can access subject headings in databases or assess credibility of a resource.

You can also create tutorials in tandem with resource guides. Just include a QR code that leads to the accompanying tutorial on the resource guide and place it in the stacks.

When creating tutorials, I recommend following these basic practices:

  • Do not choose a broad topic; keep it specific.
  • Limit the tutorial to three to five minutes. As yours will be a niche topic, keeping it limited shouldn’t be too difficult. If you do have additional information you’d like to include, create a quick part-two video.
  • Add tutorials to a YouTube playlist for this specific topic or theme. This makes the content bingeable, and patrons can easily navigate to the video most relevant to them.
  • Embed the tutorial on your library website or include a link in a visible location, like on the databases page.
  • Be sure to promote any supplemental resource guides to your video description on YouTube. You can include direct links to those resources.
  • Use closed captions or a transcript so the video is accessible to people with hearing impairments. You can enable automatic captions on YouTube or use a service like Happy Scribe for low-cost options for transcripts and subtitles.

Collection development

Collections for SRH information should be regularly reviewed for accuracy, currency, and inclusivity. When weeding materials, be mindful that many people may use the resources only in the library, and circulation statistics may therefore be lower than actual use.

So how should a public librarian weed or update an SRH collection? I encourage you to view books on SRH as a staple of your collection. In my opinion, this means that you should never be without them.

For instance, books about abortion prior to the US Supreme Court’s 2022 reversal of Roe v. Wade may now be outdated. You should scan materials for the type of language and subject matter to make sure that they are current, inclusive, and up to date. I encourage setting up a Google Alert for SRH-related topics to stay current on legislation news.

Lastly, it is crucial to have strong policies regarding collection development, library materials, challenged materials, and code of conduct.

As most public librarians are aware, book challenges are at an all-time high. ALA’s Office for Intellectual Freedom tracked 1,269 challenges to library, school, and university materials in 2022. This resulted in 2,571 unique title challenges or removals, and many of the targeted books were by or about Black or LGBTQIA+ people.

Staff training on how to best respond to patrons who are upset about library materials can help librarians feel supported and unified. Above all, a collection that contains SRH information demonstrates to your community that you care about their access to these important topics. Learn more about policies and challenge support on ALA’s website.

A collection that contains sexual and reproductive information demonstrates to your community that you care about their access to these important topics.

Useful partnerships

Community collaborations can provide an opportunity for public libraries to facilitate access to SRH and other health information on a local level. These may include collaborations with local health care organizations that can provide traditional presentations and informational partnerships.

When seeking an organization to partner with, it is important to choose one that provides credible, evidence-based information. Possibilities include health departments; local universities, including nursing colleges and medical schools; hospitals; health care community groups; health associations and coalitions; and YMCAs. Topics may include comprehensive sex education, violence prevention, sexuality, pregnancy options, menstrual health, adoption, and pregnancy prevention.

An important note about partnering with hospitals: Although Catholic hospitals make up a significant percentage of hospitals throughout the United States, they rarely provide information about or services related to sterilization, abortion, contraception, or LGBTQIA+ issues. You should keep this in mind when considering which hospitals to collaborate with for educational programs.

When considering organizations your library can partner with or what topics you can present on, you may find it helpful to conduct a community needs assessment. A community needs assessment can help you better understand what the people who live in your area need and want from the library.

An assessment can inform you about the languages your patrons speak, technology access, barriers to information and library access, and socioeconomic levels, as well as about community organizations in your area.

You can get this information from both primary and secondary sources. For instance, you may look at census records or business reports. You may also get feedback through surveys, focus groups, or one-on-one conversations.

When soliciting information from your community, you should explain how you plan to integrate feedback into library services. This work may seem complex, but it is important to building trust in your community and creating patron-centered services.


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