An early 20th century post card documents the problem of unwanted pregnancy.
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. Common avenues for sex education are parents or caregivers, school
programs, and public health campaigns.
Overview
Education about reproduction typically describes the creation and development of a new human being, from conception and the development of the embryo and fetus, through to childbirth. It often includes topics such as
sexually transmitted infections (STIs) and how to avoid them, as well as
birth control methods.
Although some form of sex education is part of the curriculum at many schools, it remains
a controversial issue in several countries, particularly with regard to the age at which
children should start receiving such education, the amount of detail that is revealed, and topics dealing with human sexuality and behavior (eg. safe sex practices, masturbation and sexual ethics).
In 1936, Wilhelm Reich commented that sex education of his time was a work of
deception, focusing on biology while concealing excitement-arousal, which is what a pubescent individual is mostly
interested in. Reich added that this emphasis obscures what he believed to be a basic psychological principle: that all worries
and difficulties originate from unsatisfied sexual impulses.[1]
In many countries, sexual education raises much contentious debate. Chief among the controversial points is whether covering
child sexuality is valuable or detrimental; the use of birth control such as
condoms and hormonal contraception; and the
impact of such use on pregnancy outside marriage, teenage pregnancy, and the
transmission of STIs. Increasing support for abstinence-only sex education
by conservative groups has been one of the primary causes of this controversy. Countries with conservative attitudes towards sex
education (including the UK and the U.S.) have a higher incidence of STIs and teenage pregnancy.[2]
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 (see HIV/AIDS in Africa), sex education is seen by most scientists as a vital public health strategy. Some international organizations such as Planned Parenthood consider that broad sex education programs have global benefits, such as
controlling the risk of overpopulation and the advancement of women's rights (see also reproductive rights).
Sex education worldwide
United States
- See also: Adolescent
sexuality in the United States and Abstinence-only sex
education
Almost all U.S. students receive some form of sex education at least once between grades 7 and 12; many schools begin
addressing some topics as early as grades 5 or 6.[3]
However, what students learn varies widely, because curriculum decisions are so decentralized. Many states have laws governing
what is taught in sex education classes or allowing parents to opt out. Some state laws leave curriculum decisions to individual
school districts.[4]
For example, a 1999 study by the Guttmacher Institute found that most U.S. sex
education courses in grades 7 through 12 cover puberty, HIV, STIs, abstinence, implications of teenage
pregnancy, and how to resist peer pressure. Other studied topics, such as methods of
birth control and infection prevention, sexual
orientation, sexual abuse, and factual and ethical information about
abortion, varied more widely.[5]
Two main forms of sex education are taught in American schools: comprehensive and abstinence-only. Comprehensive sex education covers abstinence as a positive choice, but
also teaches about contraception and avoidance of STIs when sexually active. A 2002 study conducted by the Kaiser Family Foundation found that 58% of secondary school principals describe their sex
education curriculum as comprehensive.[4]
Abstinence-only sex education tells teenagers that they should be sexually abstinent until marriage and does not provide
information about contraception. In the Kaiser study, 34% of high-school principals said their school's main message was
abstinence-only.
The difference between these two approaches, and their impact on teen behavior, remains a controversial subject in the U.S.
Since 1991, U.S. rates of teenage pregnancy have declined significantly, and a slightly higher percentage of teens say they are
abstinent.[6] However, the U.S. still has the highest teen
birth rate and one of the highest rates of STIs among teens in the industrialized world.[7] Public opinion polls conducted over the years have found
that the vast majority of Americans favor broader sex education programs over those that teach only abstinence, although
abstinence educators recently published poll data with the totally opposite conclusion.[8][9][10] Proponents of comprehensive sex education argue that sexual
behavior after puberty is a given, and it is therefore crucial to provide information about the risks and how they can be
minimized; they also claim that denying teens such factual information leads to unwanted pregnancies and STIs.
On the other hand, proponents of abstinence-only sex education object to curricula that fail to teach moral behavior; they
maintain that a morality based on sex only within the bounds of marriage is "healthy and constructive" and that value-free
knowledge of the body may lead to immoral, unhealthy, and harmful practices. Within the last decade, the federal government has
encouraged abstinence-only education by steering over a billion dollars to such programs.[11] Some states, such as California, decline the funding so that they can continue
to teach comprehensive sex education; several other states have recently joined California.[12][13][14][15] Funding for one of the federal government's two main abstinency-only
funding programs, Title V, was extended only until December 31, 2007; Congress is debating whether to continue it past that
date.[16]
The impact of the rise in abstinence-only education remains a question. To date, no published studies of abstinence-only
programs have found consistent and significant program effects on delaying the onset of intercourse.[7] In 2007, a study ordered
by the U.S. Congress found that middle school students who took part in abstinence-only sex education programs were just as
likely to have sex (and use contraception) in their teenage years as those who did not.[17] Abstinence-only advocates claimed that the study was flawed because it was too
narrow and began when abstinence-only curricula were in their infancy, and that other studies have demonstrated positive
effects.[18]
Europe
In England and Wales, sex education is not compulsory in
schools as parents can refuse to let their children take part in the lessons. The curriculum focuses on the reproductive system,
fetal development, and the physical and emotional changes of adolescence, while information about contraception and safe sex is
discretionary. Britain has one of the highest teenage pregnancy rates 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.[19]
In Scotland, the main sex education program is Healthy Respect, which focuses not
only on the biological aspects of reproduction but also on relationships and emotions. Education about contraception and sexually transmitted diseases are
included in the program as a way of encouraging good sexual health. In response to a refusal by Catholic schools to commit to the
program, however, a separate sex education program has been developed for use in those schools. Funded by the Scottish Executive, the program Call to Love focuses on encouraging children to delay sex
until marriage, and does not cover contraception, and as such is a form of abstinence-only sex education.
In France, sex education has been part of school curricula since 1973. Schools are expected to
provide 30 to 40 hours of sex education, and pass out condoms, 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.[19]
In Germany, sex education has been part of school curricula since 1970. It normally covers
all subjects concerning the growing-up process, the changing of the body, emotions, the biological process of reproduction,
sexual activity, partnership, homosexuality, unwanted pregnancies and the complications of abortion, the dangers of sexual
violence, child abuse, and sex-transmitted diseases, but sometimes also things like sex positions. Most schools offer courses on
the correct usage of contraception. There are also other media of sex education, in first place the youth magazine "Bravo", which
always contains a topic where teenagers pose questions about partnership and sexuality.
Subsidized 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.[20]
In Sweden, sex education has been a mandatory part of school education since 1956. The subject
is usually started at grades 4–6, and continues up through the grades, incorporated into different subjects such as biology and
history. In Finland, the Population and Family Welfare Federation provides to all 15-year-olds
an introductory sexual package that includes an information brochure, a condom and a cartoon love story.[21]
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 that specifically aims at school children at the age group of
nine to sixteen years. These are included as subjects in the curriculum and generally involves open and frank interaction with
the teachers. In India, there is a huge debate on the curriculum of sex education and when should it be increased.
Bangladesh, Myanmar, Nepal and
Pakistan have no coordinated sex education programs.[22]
In Japan, sex education is mandatory from age 10 or 11, mainly covering biological topics such
as menstruation and ejaculation. [21]
In China, sex education traditionally consists in reading the reproduction section of biology
textbooks. However, in 2000 a new five-year project was introduced by the China Family Planning Association to "promote
reproductive health education among Chinese teenagers and unmarried youth" in twelve urban districts and three counties. This
includes discussion about sex within human relationships as well as pregnancy and HIV prevention. [23]
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.[24]
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 programs commonly teach the 'ABC' of HIV prevention, which has been frequently
backed by the Bush Administration: a combination of abstinence (A), fidelity to your partner (Be faithful) and condom use (C).
(See Abstinence, be faithful, use a condom.) 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.[25]
Egypt teaches knowledge about male and female reproductive systems, sexual organs,
contraception and STDs in public schools at the second and third years of the middle-preparatory phase (when students are aged
12–14). There is currently a coordinated program between UNDP,
UNICEF, and the ministries of health and education to promote sexual
education at a larger scale in rural areas and spread awareness of dangers of female
circumcision.
Morality of sex education
One 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 and understanding that homosexuality isn't something
that is wrong.
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 teach 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 group in the sex education debate, the question is whether the state or the
family should teach sexual mores. They believe that sexual mores
should be left to the family, and sex-education represents state interference. They claim that some sex education curricula break
down pre-existing notions of modesty and encourage acceptance of practices that those advocating
this viewpoint deem immoral, such as homosexuality and premarital sex. They cite web sites such as that of the Coalition for Positive Sexuality as examples. Naturally, those that believe that
homosexuality and premarital sex are a normal part of the range of human sexuality disagree with them.
Many religions teach that sexual behavior outside of marriage is immoral, so their adherents feel that this morality should be
taught as part of sex education. Other religious conservatives believe that sexual knowledge is unavoidable, hence their
preference for a curricula based on abstinence.[26]
Lesbian, gay, bisexual, and transgender youth
Youth seeking his father's advice on love
From the
Haft Awrang of
Jami, in the story
A Father Advises his Son About Love. His
counsel is to choose that lover who desires him for his inner beauty.
See Sufi outlook on male
love Freer and Sackler Galleries,
Smithsonian Institution,
Washington, DC.
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 these activities' different risk levels for sexually transmitted
diseases.
Some people do not agree with comprehensive sexual education that references or discusses such practices, believing that
including this additional information might be seen as encouraging homosexual behavior. 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 for students who belong or believe they may belong to one of these
categories, or are unsure of their sexual identity. 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 these students. In the absence of such discussion, these youths are said to be de
facto forced to remain in the closet, while youths are left without guidance on dealing
with their own possible same-gender attractions and with their LGBT 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 are often unable to
marry a partner due to legal restrictions. Proponents of abstinence-only education
often have a more conservative view of homosexuality and bisexuality and are against them being taught as normal, acceptable
orientations, or placed in equal footing to heterosexual acts/relations, and so they generally do not see this as a problem.
While supporters of comprehensive programs feel that this is a major problem as it could lead GLBT
youth to feel even more alienated and shameful of their sexual orientation.
Scientific study of sex education
The debate over teenage pregnancy and STDs has spurred some research into the
effectiveness of different approaches to sex education. In a meta-analysis, DiCenso et al. have compared comprehensive sex
education programs with abstinence-only programs.[27] Their review of several studies shows that abstinence-only programs did not reduce the
likelihood of pregnancy of women who participated in the programs, but rather 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 programs 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.[28] In contrast, the rates are:
- We should examine effective programs designed to prevent other high risk behaviors in adolescents. For example, Botvin
et al. found that school based programs to prevent drug abuse during junior
high school (ages 12–14 years) resulted in important and durable reductions in use of
tobacco, alcohol, and cannabis 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)."[27]
Also, a U.S. review, "Emerging Answers", by the National Campaign To Prevent Teenage Pregnancy examined 250 studies of sex
education programs.[30] The conclusion of this
review was that "the overwhelming weight of evidence shows that sex education that discusses contraception does not increase
sexual activity".
See also
Notes
- ^ Reich (1936) Die
Sexualität im Kulturkampf. Part one "the failure.." 6. The puberty problem - (3°) "A reflection.." - c. sexual
relationships of pubescents - paragraph 4.a (pp.198-9 of italian edition)
- ^ "Joy of sex
education" by George Monbiot, The Guardian, 11 May 2004
- ^ (September/October 2000) "Sexuality Education in Fifth and
Sixth Grades in U.S. Public Schools, 1999". Family Planning Perspectices 32 (5). Retrieved on 2007-05-23.
- ^ a b Sex Education in the U.S.: Policy and Politics (PDF). Issue Update. Kaiser Family Foundation (October 2002).
Retrieved on 2007-05-23.
- ^ (September/October 2000) "Changing Emphases in Sexuality Education
In U.S. Public Secondary Schools, 1988-1999". Family Planning Perspectives 32 (6).
See especially Table 3.
- ^ National
Youth Risk Behavior Survey: 1991-2005 (PDF). U.S. Department of Health and Human Services: Centers for Control and
Prevention. Retrieved on 2007-05-25.
- ^ a b
- ^ Dailard, Cynthia (February 2001). Sex Education: Politicians, Parents,
Teachers and Teens. The Guttmacher Report on Public Policy. Guttmacher Institute. Retrieved on 2007-05-23.
- ^ On Our Side: Public Support for Comprehensive Sexuality Education (Fact Sheet). SIECUS.
Retrieved on 2007-05-23.
- ^ NAEA
Executive Summary of Key Findings. National Abstinence Education Association (2007-05-03). Retrieved on 2007-05-24.
- ^ Abstinence-Only Programs: Harmful to Women & Girls: Federal Funding for Abstinence-Only
Programs. Legal Momentum. Retrieved on 2007-05-25.
- ^ States that decline abstinence-only funding include California,
Connecticut, Maine, Montana, New Jersey, Pennsylvania, Ohio, Rhode Island, Washington, and Wisconsin.
- ^ "Maine Declines Federal Funds for Abstinence-Only Sex Education Programs, Says New Guidelines
Prohibit 'Safe-Sex' Curriculum", Medical News Today, 2005-09-23. Retrieved on 2007-05-24.
- ^ Huffstutter, P.J.. "States refraining from abstinence-only sex education", Boston Globe, Los Angeles Times,
2007-04-09. Retrieved on 2007-05-23.
- ^ An Overview of
Federal Abstinence-Only Funding (PDF). Legal Momentum (February 2007). Retrieved on 2007-05-25.[1]
- ^ Mixon, Melissa. "Abstinence programs brace for major funding cut", Austin American-Statesman, 2007-10-06. Retrieved on 2007-10-17.
- ^ "Study: Abstinence programs no guarantee", CNN.com, Associated Press, 2007-04-14. Retrieved on 2007-04-18.
- ^ National Abstinence Education Association (2007-04-13). Mathematica
Findings Too Narrow. Press release. Retrieved on 2007-05-25.
- ^ a b Britain: Sex Education Under Fire UNESCO Courier
- ^ The Dutch model UNESCO
Courier
- ^ a b Sex Has Many Accents TIME
- ^ 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
- ^ Sex education begins to break taboos China Development Brief, 2005-06-03
- ^ Involve The Young! Interview
with Dr Pramilla Senanayake, assistant director-general of the International Planned Parenthood Federation
- ^ Uganda reverses the tide of HIV/AIDS
- ^ PBS, February 4, 2005 Religion & Ethics
Newsweekly, Episode 823 Accessed 2006-12-30
- ^ a b DiCenso A. et al.: Interventions to Reduce
Unintended Pregnancies Among Adolescents: Systematic Review of Randomized Controlled Trials. British Medical Journal 2002;324:1426.
- ^ Ketting, E. & Visser, A., Contraception in the
Netherlands: the low abortion rate explained. Patient Education and Counseling 23
- ^ www.ethesis.net {in Dutch)
- ^ 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.
External links
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