Key Social Norms Take-aways Gendered social norms that shame adolescent girls for being sexually active are central to the stigma they face. These norms create major barriers to accessing family planning and must be directly challenged through stigma-reduction strategies.

Objectives This study examined how sexual and reproductive health (SRH) stigma affects adolescent girls’ ability to access and use family planning (FP) services in Ghana. The goal was to develop a conceptual model showing how different forms of stigma interact to shape FP outcomes among young women.

Methods Researchers conducted in-depth, semi-structured interviews with 63 adolescent and young adult women (ages 15–24) from schools and health facilities in Accra and Kumasi. A grounded theory approach was used to analyze the data, with themes developed both inductively and from existing literature on stigma.

Results The study identified five interrelated forms of SRH stigma: (1) Community norms portrayed premarital sex, pregnancy, abortion, and contraceptive use as immoral, labeling girls who engage in them as “bad girls”; (2) Enacted stigma involved rejection and mistreatment from peers, families, and healthcare providers; (3) Internalized stigma led girls to feel shame and unworthiness; (4) Non-disclosure was used to hide SRH behaviors, but this secrecy often kept girls from seeking care; and (5) Stigma resilience, though rare, helped some manage stigma with support from family or community.

Conclusions Stigma tied to adolescent sexuality contributes to unmet FP needs and is reinforced by peers, families, religious leaders, and healthcare providers. Addressing stigma through community-level change and youth-centered health systems is critical.