Sex education

Sex education is a broad term used to describe education about human sexual anatomy, sexual reproduction, sexual intercourse, and other aspects of human sexual behavior.

Overview

Education on reproduction typically describes the process of a new human being coming into existence in stages including conception, the development of the embryo and fetus, and the birth of the new baby. It often includes topics such as sexually transmitted diseases (STD) and how to avoid them, as well as methods of contraception.

Although some sort of sex education is part of many schools' curriculum, it remains a controversial topic in several countries as to how much and at which age schoolchildren should be taught about contraception or safer sex, and whether moral education should be included or excluded (see sexual morality).

In the United States in particular, the topic is the subject of much contentious debate. Chief among controversial points is whether sexual freedom for minors is valuable or detrimental, as well as whether instruction about condoms and birth control pills reduces or increases out-of-wedlock or teenage pregnancy and STDs. The existence of AIDS has given a new sense of urgency to the topic of sex education. In many African nations, where AIDS is at epidemic levels, sex education is seen by most scientists as a vital strategy for preserving the health of citizens. Some international organizations such as Planned Parenthood see worldwide benefit to sex education programs, such as the control of overpopulation and advancement of the rights of women.

Sex education worldwide

United States

Most parents in the U.S. feel that teenagers should remain sexually abstinent, but should have access to contraception. Almost 60% of adults also think that sexually active teenagers should have access to contraception.The National Campaign to Prevent Teen Pregnancy A 1997 study found that about 48% of high school students are sexually active.

In the U.S. some advocates including President George W. Bush have successfully worked toward the introduction of "abstinence-only" curricula. Under such instruction, teens are told that they should be sexually abstinent until adulthood and/or marriage, and information about contraception is not provided. Opponents argue this approach denies teens needed, factual information and leads to unwanted pregnancies, abortions, and propagation of STDs.

Some curricula are advocated on the grounds that they are intended to reduce sexual disease or out-of-wedlock or teenage pregnancy, but no abstinence-only program has ever been shown to reduce teen sexual activity, pregnancy, or STDs. A curriculum ostensibly aimed at reducing pregnancy among high school students, which advocates the use of condoms, could potentially lower the pregnancy rate. Proponents of this view argue that sexual behaviour after puberty is a given, and it is therefore crucial to provide information about the risks and how they can be minimized. They hold that conventional or conservative moralizing will put off students and thus weaken the message.

In turn, opponents of comprehensive sexuality education object that curricula which fail to teach moral behaviour actually serve to prevent children from making informed decisions; they maintain that curricula should include the claim that conventional (or conservative) morality is "healthy and constructive", and that value-free knowledge of the body may lead to unhealthy and harmful practices.

In December of 2004 Henry A. Waxman, a United States Congressman from California, released a report that provides several examples of inaccurate information being included in federally funded abstinence-only sex education programs. This report bolstered the claims of those Americans arguing that abstinence-only programs deprive teenagers of critical information.

The August 29/September 5, 2005, issue of The Nation reported that money from the Federal Government used to create high school abstinence clubs was being used to train "young abstinence advocates", who were being encouraged to engage in politics and support issues like overturning abortion. The article states that although the program's official language has been secularized, a list of its grant recipients "reads like a who's who list of the religious right."

Europe

In the United Kingdom, sex education is compulsory in secondary school, but parents have the right to withdraw their children from lessons. The curriculum focuses on the reproductive system, foetal development, and the physical and emotional changes of adolescence, while information about contraception and safe sex is discretionary. Britain has the highest teenage pregnancy rate in Europe and sex education is a heated issue in government and media reports. In a 2000 study by the University of Brighton, many 14 to 15 year olds reported disappointment with the content of sex education lessons and felt that lack of confidentiality prevents teenagers from asking teachers about contraception. Britain: Sex Education Under Fire UNESCO Courier

In France, sex education has been part of school curricula since 1973. Schools are expected to provide 30 to 40 hours of sex education to students in grades eight and nine. In January 2000, the French government launched an information campaign on contraception with TV and radio spots and the distribution of five million leaflets on contraception to high school students.

Subsidised by the Dutch government, the “Lang leve de liefde” (“Long Live Love”) package, developed in the late 1980s, aims to give teenagers the skills to take their own decisions regarding health and sexuality. Nearly all secondary schools provide sex education as part of biology classes and over half of primary schools discuss sexuality and contraception. The curriculum focuses on biological aspects of reproduction as well as on values, attitudes, communication and negotiation skills. The media has encouraged open dialogue and the health-care system guarantees confidentiality and a non-judgmental approach. The Netherlands has one of the lowest teenage pregnancy rates in the world, and the Dutch approach is often seen as a model for other countries. *The Dutch model UNESCO Courier

Asia

The state of sex education programs in Asia is at various stages of development. Indonesia, Mongolia, South Korea and Sri Lanka have a systematic policy framework for teaching about sex within schools. Malaysia, the Philippines and Thailand have assessed adolescent reproductive health needs with a view to developing adolescent-specific training, messages and materials. India has programs specifically aimed at female adolescents. Bangladesh, Myanmar, Nepal and Pakistan have no coordinated sex education programs. Adolescents In Changing Times: Issues And Perspectives For Adolescent Reproductive Health In The ESCAP Region United Nations Social and Economic Commission for Asia and the Pacific

The International Planned Parenthood Federation and the BBC World Service ran a 12-part series known as Sexwise, which discussed sex education, family life education, contraception and parenting. It was first launched in South Asia and then extended worldwide. Involve The Young! Interview with Dr Pramilla Senanayake, assistant director-general of the International Planned Parenthood Federation

Africa

Sex education in Africa has focused on stemming the growing AIDS epidemic. Most governments in the region have established AIDS education programs in partnership with the World Health Organization and international NGOs. These programmes commonly teach the 'ABC' of HIV prevention: a combination of abstinence (A), fidelity to your partner (Be faithful) and condom use (C). The efforts of these educational campaigns appear now to be bearing fruit. In Uganda, condom use has increased, youths are delaying the age at which sexual intercourse first occurs, and overall rates of HIV infection have been going down. Uganda reverses the tide of HIV/AIDS

Morality of sex education

A common approach to sex education is to view it as necessary to reduce risk behaviours such as unprotected sex, and equip individuals to make informed decisions about their personal sexual activity. Additionally, some proponents of comprehensive sex education contend that education about homosexuality encourages tolerance, while many conservatives believe that sexuality is a subject that should be taught in the home.

Another viewpoint on sex education, historically inspired by sexologists like Wilhelm Reich and psychologists like Sigmund Freud and James W. Prescott, holds that what is at stake in sex education is control over the body and liberation from social control. Proponents of this view tend to see the political question as whether society or the individual should dictate sexual mores. Sexual education may thus be seen as providing individuals with the knowledge necessary to liberate themselves from socially organized sexual oppression and to make up their own minds. In addition, sexual oppression may be viewed as socially harmful.

To another large and vocal group in the sex education debate, the political question is whether the state or the family should dictate sexual mores. They believe that sexual mores should be left to the family, and sex-education represents state interference. They also claim that some sex education curricula are intended to break down pre-existing notions of modesty and encourage acceptance of practices they deem immoral, such as homosexuality and premarital sex. They cite web sites such as that of the Coalition for Positive Sexuality as examples.

If a person explains sexual matters to a child without a formal education program and without consent from the parents this may be considered inappropriate, and may in some cases be interpreted as suspicious child grooming.

Lesbian, gay, bisexual, and transgender youth

Lesbian, gay, bisexual, and transgender (LGBT) youth are often ignored in sex education classes, including a frequent lack of discussion about safer sex practices for manual, oral, and anal sex, despite a lack of different risk levels for sexually transmitted diseases. Some people do not agree with comprehensive sexual education that references or discusses such practices, as including this additional information might be seen as 'encouraging homosexual behavior'. However, proponents of such comprehensive curricula hold that by excluding discussion of these issues or the issues of homosexuality, bisexuality, or transgenderedness, feelings of isolation, loneliness, guilt and shame as well as depression are made much worse. Supporters of including LGBT issues as an integral part of comprehensive sexuality education argue that this information is still useful and relevant and reduces the likelihood of suicide, sexually transmitted disease, acting out and maladaptive behavior. In the absence of such discussion, these youths are said to be de facto forced to remain in the closet, while heterosexual youth is left without guidance on dealing with their own possible homosexual attractions and with their homosexual classmates.

Supporters of comprehensive sex education programs argue that abstinence-only curricula that advocate that youth should abstain from sex until marriage ignore and marginalize lesbian, gay, bisexual, and transgender youth, who might not be able to marry their partner due to legal restrictions. Proponents of abstinence-only education often have a more conservative view of homosexuality and are against it being taught as a normal, accepted lifestyle, or placed on the same platform as heterosexual relations, and so they generally do not see this as a problem.

Scientific study of sex education

The debate over teenage pregnancy and STDs has spurred some research into the effectiveness of different sex education approaches. In a meta-analysis, DiCenso et al. have compared comprehensive sex education programs with abstinence-only programs. DiCenso A. et al.: Interventions to Reduce Unintended Pregnancies Among Adolescents: Systematic Review of Randomized Controlled Trials. British Medical Journal 2002;324:1426. Their review of several studies shows that abstinence-only programs not only did not reduce the likelihood of pregnancy of women who participated in the programs, but that 'abstinence- only' actually increased it. Four abstinence programs and one school program were associated with a pooled increase of 54% in the partners of men and 46% in women (confidence interval 95% 0.95 to 2.25 and 0.98 to 2.26 respectively). The researchers conclude:

"There is some evidence that prevention programmes may need to begin much earlier than they do. In a recent systematic review of eight trials of day care for disadvantaged children under 5 years of age, long term follow up showed lower pregnancy rates among adolescents. We need to investigate the social determinants of unintended pregnancy in adolescents through large longitudinal studies beginning early in life and use the results of the multivariate analyses to guide the design of prevention interventions. We should carefully examine countries with low pregnancy rates among adolescents. For example, the Netherlands has one of the lowest rates in the world (8.1 per 1000 young women aged 15 to 19 years), and Ketting & Visser have published an analysis of associated factors.Ketting, E. & Visser, A., Contraception in the Netherlands: the low abortion rate explained.'' Patient Education and Counseling 23 In contrast, the rates are:

93.0 per 1000 in the United States (85.8/1000 in 1996)
62.6 per 1000 in England and Wales, and
42.7 per 1000 in Canada
15.1 per 1000 in Belgium (1996)www.ethesis.net {in Dutch)

''We should examine effective programmes designed to prevent other high risk behaviours in adolescents. For example, Botvin et al. found that school based programmes to prevent drug abuse during junior high school (ages 12-14 years) resulted in important and durable reductions in use of tobacco, alcohol, and marijuana if they taught a combination of social resistance skills and general life skills, were properly implemented, and included at least two years of booster sessions.

''Few sexual health interventions are designed with input from adolescents. Adolescents have suggested that sex education should be more positive with less emphasis on anatomy and scare tactics; it should focus on negotiation skills in sexual relationships and communication; and details of sexual health clinics should be advertised in areas that adolescents frequent (for example, school toilets, shopping centres)."

Also, in answer to the criticism of conservatives, a US review, "Emerging Answers", by the National Campaign To Prevent Teenage Pregnancy examined 250 studies of sex education programs.Douglas Kirby, Ph.D.: Emerging Answers: Research Findings on Programs to Reduce Teen Pregnancy. National Campaign to Prevent Teen Pregnancy, 2001. Homepage of the study. The conclusion of this review was that "the overwhelming weight of evidence shows that sex education that discusses contraception does not increase sexual activity". Regarding abstinence-only programs, the summary notes:

"Emerging Answers says that the jury is still out about the effectiveness of abstinence-only programs. That is, current evidence about the success of these programs is inconclusive. This is due, in part, to the very limited number of high-quality evaluations of abstinence-only programs available and because the few studies that have been completed do not reflect the great diversity of abstinence-only programs currently offered. However, the early evidence about abstinence-only programs is not encouraging. Fortunately there is currently a high-quality, federally-funded evaluation of abstinence-only programs under way which should offer more definitive results soon."

There is a movement separate from school-based programs to encourage sexual abstinence; scientific research on these programs indicates decreased use of contraceptives among participants who become sexually active (see sexual abstinence).

References

Sex information website by the "Nederlandse Vereniging voor Seksuele Hervorming" (Dutch Society for Sexual Reform)

Notes

External links

Patterns of Deceit Raise Concerns About Teenage Sex Surveys in The New York Times, about false virginity pledges
The Dutch model UNESCO Courier on the success of the Netherlands.
Sex, AIDS, and the Pursuit of Happiness
Born Again Virgins and the Tyranny of Mandatory Chastity
TechnicalVirgin A parody of abstinence programs
Itsteens.com An online magazine for teen issues
Gethsemene Rose Abstinence education reaching teens through humor
Sexwise Sex information for teenagers in the UK
sarilocker.com Popular sex educator, Sari Locker, provides advice and information
Youth-Policy Youth reproductive health and HIV/AIDS policy in developing countries
Project Growing Up Sexually
TeenSource California site for teens

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