Associations between Developing Sexuality and Mental Health in Heterosexual Adolescents: Evidence from Lower- and Middle-Income Countries—A Scoping Review

Round 1

Reviewer 1 Report

The paper presents an interesting and pertinent objective that serves different purposes, including the possibility of identifying implications for practice and informing public policy.
The methodology adopted is robust and well explained, considering the research for an extended period and a wide set of databases.
The methodological process is clearly explained and described and the results consider the selected studies, with interesting identification and analysis of themes and sub-themes. 
The fact that the research and analysis focus on a specific population group and on countries in particular contexts (LIMC) allows for more focused, detailed analysis and the identification of challenges that arise in these contexts, with a greater possibility of obtaining relevant results for intervention.
I also consider that some aspects could be improved or better justified:
- At the end of section 1.1. appears a set of sentences that do not belong to the text (it seems to be a review text of the article).
- It is not clear the criteria used to delimit, in age terms, the population under study (in fact, it seems to have selected adolescents and young adults, from 11 to 24 years old, which does not correspond to what is said in some parts of the article, including the title).
- Despite the reference in the limitations, the application of the exclusion criteria to the lesbian, bisexual, queer and transgender population is neither clear nor discussed.

Author Response

Reviewer 2 Report

The work presented is of enormous interest and relevance. Although the development of sexuality has been extensively researched, its relationship to mental health has been little addressed in the literature.

Here are some aspects that should be taken into account in order to improve the work:
- The title should state that the article is a review.
- The search is too old. Review articles should be from the last 6 months at the latest. In this case it is a review carried out 4 years ago. 

Author Response

Reviewer 3 Report

In the abstract: Results section, you have listed number 4 twice.

Introduction:

It may be a paraphrase, but the WHO definition of sexuality feels close to a direct quote. Either paraphrase or directly quote, as it informs your study. 

It would further be beneficial to include why you have highlighted gender in the definition - this shows up again in the discussion but not elsewhere explicitly in the paper.

The end of the introduction before the Aim, there is a 6 sentences that are copied from author instructions.

Methods:

Study Eligibility Criteria, you have noted populations you did not include but not why.

Results:

3rd paragraph of first section has a sentence, "However, it was not possible to perform a  gender analysis as gender- specific results were not reported in the primary studies." What does "gender- specific results" mean in this context? In the discussion more studies with girls than boys is discussed, is this what you mean? Or are you talking about the difference between transgender and cisgender studies? 

I especially appreciated the direct quotes and notes of themes in the qualitative papers, I did not see any specific statistics or data from the quantitative studies referenced in results. It would be helpful to know what if there were any noteworthy results from those studies as well. 

Great job, this was a very interesting paper!

Author Response

Round 2

Reviewer 2 Report

The modifications made by the authors meet the demands made by this reviewer.