Abstract
<sec> <title>BACKGROUND</title> <p>In the United States, Black girls and women are disproportionately affected by sexually transmitted infections (STIs), HIV, and sexual violence [1-3]. The "fast-tailed girl" (FTG) narrative, a gender-specific pejorative suggesting a girl is intentionally demonstrating sexual behaviors reserved for adults, has persisted in Black communities for generations and intersects with broader patterns of adultification bias that deny Black girls the protections of childhood [4-6]. Social media platforms have become significant sites where this harmful narrative is both perpetuated and contested [7,8].</p> </sec> <sec> <title>OBJECTIVE</title> <p>This study examines Twitter discourse surrounding the #FastTailedGirl hashtag to understand how this narrative manifests online, its implications for Black women's and girls' sexual development and health, and how community members resist this harmful trope.</p> </sec> <sec> <title>METHODS</title> <p>Using Brandwatch, we retrieved 34,485 English-language tweets containing #fasttailedgirl and related permutations posted between 2011 and 2021, with retweets excluded. Tweets identified as originating outside the United States were excluded. Tweets with no country code available were retained because missing geographic metadata do not indicate that a tweet originated outside the United States. This yielded an eligible dataset of 33,099 tweets, from which a 20% random sample (N=6,899) was selected for qualitative analysis. We analyzed this sample using reflexive thematic analysis informed by intersectionality and reproductive justice frameworks [9,10]. After tweets coded as irrelevant or lacking sufficient context (code 99; n=678) were removed, the final thematic analytic sample included 6,221 tweets.</p> </sec> <sec> <title>RESULTS</title> <p>Two overarching themes emerged: (1) a culture of acceptance, encompassing blaming and shaming of Black girls, sexualization and predatory behavior, denial of childhood, generational transmission, and long-term consequences including under-reporting of sexual assault; and (2) resistance through provocation and inquiry, including myth-busting, activism and advocacy, and reclaiming self and body autonomy.</p> </sec> <sec> <title>CONCLUSIONS</title> <p>The FTG narrative represents a significant public health concern that may reflect and reinforce conditions shaping sexual and reproductive health inequities among Black women and girls. Findings point to an urgent need for culturally responsive digital and community-based interventions that counter stereotype messaging, create safe spaces for empowerment, and support healing from trauma.</p> </sec> <sec> <title>CLINICALTRIAL</title> <p>Not Applicable</p> </sec>