The multiple realities around the sexual and reproductive health of Ghanaian adolescents are explored in this paper. Female and male adolescents (aged 10–19 years, N=298) participated in 40 focus group discussions in 20 communities. A comparative inductive approach has been used to present, analyse and document the sexual and reproductive realities of adolescents in their communities. The findings reveal commonalities as well as differences in the realities among participants. Common realities, regardless of age and sex, were teenage pregnancy and abortion, sexual violence (defilement, rape and coercive sex) and parental neglect. These aside, there were divergent realities for older adolescent girls in particular, e.g. lack of access to contraceptives and understanding of the fertility cycle, and the influences and pressures of social media and varied notions about sexual harassment between female and male adolescents. The findings, overall, underscore the complexity and nuanced lives of adolescents in traversing the sexual and reproductive maturation processes. These events unfold in communities where adolescents are ‘required’ to be silent and ‘play’ innocent regardless of their daily struggles, compounded by limited opportunities to learn and unlearn embedded norms about sexual and reproductive functioning. Some implications for sexual health promotion programmes are outlined.

本文探讨了加纳青少年性健康和生殖健康的多重现实。女性和男性青少年（10-19 岁，N=298) 参加了 20 个社区的 40 次焦点小组讨论。比较归纳法已被用于呈现、分析和记录社区中青少年的性和生殖现实。调查结果揭示了参与者之间现实的共性和差异。不论年龄和性别，共同的现实是少女怀孕和堕胎、性暴力（污秽、强奸和强迫性行为）和父母忽视。除此之外，尤其是对于年龄较大的少女来说，存在着不同的现实，例如缺乏避孕药具和对生育周期的了解，以及社交媒体的影响和压力以及关于女性和男性青少年之间性骚扰的不同观念。总体而言，调查结果 强调青少年在性成熟和生殖成熟过程中的复杂性和微妙的生活。这些事件发生在青少年被“要求”保持沉默和“玩”无辜的社区，不管他们的日常斗争如何，再加上学习和忘记有关性和生殖功能的嵌入式规范的机会有限。概述了对性健康促进计划的一些影响。