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Sex Education
 

This section has been designed with the aim to streamline appropriate knowledge that will help develop positive attitudes among young people and the stakeholders on sexuality and its education. Win a surprise in the end!

The Need For Sex Education:

Young people can be exposed to a wide range of attitudes and beliefs in relation to sex and sexuality. These sometimes appear contradictory and confusing. For example, some health messages emphasize the risks and dangers associated with sexual activity and some media coverage promotes the idea that being sexually active makes a person more attractive and mature.  Young people are very interested in the moral and cultural frameworks that bind sex and sexuality. They often welcome opportunities to talk about issues where people have strong views, like abortion, sex before marriage, lesbian and gay issues and contraception and birth control.

Young people in the contemporary times are increasingly facing challenging lifestyles yet dialogue between the sexes remains difficult. Changing sexual behaviour and attitudes are leading to unintended pregnancies, abortions, STDs and HIV/AIDS. But beyond this depressing scenario comes a ray of hope. Young people are now becoming more assertive about their sexuality and eager to learn about how to prevent sexually transmitted diseases and to protect their health.

Young people need the right information to help protect themselves. Some data that has emerged from the US on adolescent sexuality is not encouraging which perhaps hastens the need for accurate scientific information. The US has more than double the teenage pregnancy rate of any western industrialized country, with more than a million teenagers becoming pregnant each year (1).  Teenagers have the highest rates of sexually transmitted diseases (STDs) of any age group, with one in four young people contracting an STD by the age of 21 (2).

STDs including HIV can damage teenager’s health and reproductive ability. And still there is no cure for AIDS.

Young people start their sexual lives at an early age in South Asia and frequently face serious health risks as a result. Too little factual information is available, too little guidance on offer and too little access to health care provided. In the new millennium, few young people in South Asia have access to sex education and contraceptive services. And those who do are often embarrassed to access them; traditional values and unwelcoming attitudes are some of the reasons.

  Sex Education- Concepts: and beliefs about sex, sexual identity, relationships and intimacy. It is also about developing young peoples’ skills so that they make informed choices about their behaviour, and feel confident and competent about acting on these choices. It is widely accepted that young people have a right to sex education, partly because it is a means by which they are helped to protect themselves against abuse, exploitation, unintended pregnancies, sexually transmitted diseases and HIV/AIDS. (3)

  Sex Education - Aims:

Youth, though an exciting period of life, can also be stressful. Heightened biological, physical and emotional changes can bewilder the young people.

In this period, young people tend to explore their bodies and relationships, assert their independence, establish their own identity, accept social and personal responsibility, exercise judgment & practice the skills necessary to become productive members of society.  This is influenced by the hormonal or biological changes that take place during this phase of development.

Sex education seeks to provide a scientific information base on the basic physiology of the sexual organs, enhance the quality of relationships among young people, help them develop a positive sexual identity, reduce the risks of potentially negative outcomes from sexual behaviour like unwanted or unplanned pregnancies and infections with sexually transmitted diseases etc. It is also about developing young people’s ability to make decisions over their entire lifetime. Sex education that works, by which we mean that it is effective, is sex education that contributes to this overall aim. If sex education is going to be effective it needs to include opportunities for young people to develop skills, as it can be hard for them to act on the basis of only having information (4)

Important skills include being able to recognize pressures from other people and to resist them, deal with and challenge prejudices, seek help from adults including parents, carers and professionals – through the family, community and health and welfare services. Sex education that works, also helps equip young people with the skills to be able to differentiate between accurate and inaccurate information, discuss a range of moral and social issues and perspectives on sex and sexuality, including different cultural attitudes and sensitive issues like sexuality, abortion and contraception (5)

  Ingredients for success in sex Education:

 It is important to provide information which educates in all aspects of positive sexuality, including birth control, safe sex and sexually transmitted diseases, masturbation and self pleasuring anatomy, diverse sexual orientation and identification, sexual and romantic relationship and communication tools, and care and compassion in sexual technique and practise.

A survey of students in five colleges in Bombay by Gurmeet Hans (Tata Institute for Social Sciences, unpublished, 1992) revealed that young people who visit the SECRT centres (Sex education, counselling, research, training/therapy branch of FPAI) expressed their concerns as follows:

·        Sexuality (all aspects e.g. body image)

·        Acceptance by peers

·         Pre-marital sex

·        Emotional problems

·         Masturbation

·        Marriage

·        Night emissions

·        Menstrual disorders

·        Acne

·        AIDS/STIs/RTIs

·        Contraception

·        Dental problems

·        Fear of cancer

·        Nutrition

·        Growth

·        Exercise

·        Weight problems

It also revealed that students felt the need for guidance about physical health, human relations, self-development and their future roles as adults.

Young people thought they could expect sex education and vocational guidance as well as advice on personal issues from teachers but some preferred a combination of services from teachers and professionals.

 

As a result of this survey, further study is needed to look into the significant events in a young person’s life, such as sexual maturation, couple formation etc.

In another case, a review of 23 studies found that effective sex education programs share the following characteristics (6)

1.      Narrow focus on reducing sexual risk taking behaviours that may lead to HIV/STD infection or unintended pregnancy.

2.      Social learning theories as a foundation for program development, focusing on recognizing social influences, changing individual values, changing group norms, and building social skills.

3.      Experimental activities designed to personalize basic, accurate information about the risks of unprotected intercourse and methods of avoiding unprotected intercourse.

4.      Activities that address social or media influences on sexual behaviours

5.      Reinforcing clear and appropriate values to strengthen individual values and group norms against unprotected sex.

6.      Modelling and practices in communication, negotiation, and refusal skills.

 

·        A successful sex education module for young people needs to demonstrate the personal, social and medical dimensions and provide physical and psychological solutions. An example of one such programme put together after surveying many successful Indian and International programmes is shown below. The programme in India was successfully used in the project Spearhead Youth Health where young peer group counsellors were trained. The post evaluation comments and subsequent core of young people helping the FPAI indicates its success.

Sex education

Personal:

·        Human physiology

·        Problems and options of adolescents

·        Nutrition

·        Changes at puberty

·        Hygiene

·        Child parent conflict

·        Self esteem

Social:

·        Relationships

·        Love

·        Responsibilities

·        Life styles

·        Family planning

·        Parenthood

·        Alternative sexuality

Problems:

·        Smoking/alcoholism

·        Drug abuse

·        Prostitution

·        Child abuse

·        STDs, HIV/AIDS

·        Other unwanted sexual behaviours

Knowledge alone is not enough to change behaviours (7). Programs that rely mainly on conveying information about sex or moral precepts – how the body’s sexual system functions, what teens should and shouldn’t do have failed. However, programs that focus on helping teenagers to change their behaviour- using role-playing games, and exercises that strengthen social skills have shown signs of success (8)

 Existing scenario on sex educating globally 

In the US, controversy over what message should be given to children has hampered sex education programs in schools (9). Other countries have been much more successful than the US in addressing the problem of teen pregnancies. Age at first intercourse is similar in the US and five other countries: Canada, England, France, the Netherlands and Sweden, yet all those countries have teen pregnancy rates that are at least less than half the US rates (10). Sex education in these countries is based on the following components: a policy explicitly favouring sex education; openness about sex, consistent messages throughout society, and access to contraception.

Reducing the risk, a program for high school students in urban and rural areas in California, used behaviour theory based activities to reduce unprotected intercourse, either by helping teens avoid sex or use protection. Ninth and tenth grade students attended 15 sessions as part of their regular health education classes and participated in role playing and experimental activities to build skills and self-efficacy. As a result, a greater proportion of students who were abstinent before the program successfully remained abstinent, and unprotected intercourse was significantly reduced for those students who became sexually active (11)

 

Postponing sexual involvement, a program for African-American 8th graders in Atlanta, GA, used peers (11th and 12th graders) to help youth understand social and peer pressures to have sex, and to develop and apply resistance skills. A unit of the program also taught about human sexuality, decision-making, and contraceptives. This program successfully reduced the number of abstinent students who initiated intercourse after the program, and increased contraceptive use among sexually experienced females (12).

 

Healthy Oakland teens (HOT) target all 7th graders attending a junior high school in Oakland, CA. Health educators teach basic sex and drug education, and 9th grade peer educators lead interactive exercises on values, decision making, communication and condom use skills. After one year, students in the program were much likely to initiate sexual activities such as deep kissing, genital touching and sexual intercourse.

Steps towards sex education:

The challenge before us lies in changing the mindset of people who work with young people. Providers need to adopt a holistic approach to problems rather than bombarding them with single issues that merely frustrate them.

Peers, parents, policy makers, educators and donors need to analyse together the positive and negative factors that confuse young people and produce basic guidelines to serve both the rural and the urban population as well as established and marginalized sections of society.

 

Young people’s needs are broad and diverse. Services and educational programmes must operate within the contemporary realities of their sexual behaviour, in turn expressed by social, cultural and gender relations.

 

 Education will lead to demand so must always be accompanied by services. Youth friendly services are available which specifically cater to the needs of the youth in terms of counselling, providing information and establishing linkages with other organizations or resource personnel on issues related to sexual and reproductive health.    The mindset of providers that says “we know best” must change to “they know best but we can help”. Young people should be actively involved in programmes so they can explore their own attitudes, values and sexual behaviour.

 

Educators, parents and policy makers should avoid emotional misconceptions about sex education; based on the rates of unintended pregnancies and STDs including HIV among teenagers, we can no longer ignore the need for both education on how to postpone sexual involvement, and how to protect oneself when sexually active. Our children deserve the best education they can get.

Conclusive remarks!

Education is not just encouragement, and it is that which allows anyone, regardless of age, to best choices throughout one’s lives. This coupled with open and loving care and communication from parents, other educators, teachers and other respected adults, and a confidence in individual choices and relationships is the foundation for lifelong sexual and emotional health. Sound knowledge and understanding of sexuality not only equips a teen with what is needed to make informed choices but an understanding of sexual anatomy, boundaries and what they may and may not want to participate in benefits them whether they choose to be sexually active or not. 

Studies indicate that furnishing the adolescents with facts they need to know regardless of whether or not they are sexually active readies them to learn to make their own choices, and develop their own systems of ethics and values from themselves and their families. These same studies show that informative sex education has not increased sexual activity, pregnancy or the number of sexual partners, and has infact, succeeded in that, “Teenagers who start having intercourse following a sexuality education program are more likely to use contraception than those who have not participated in a program (SIECUS).

 

 

References:

(1) Centres for disease control and prevention. Youth risk behaviour surveillance-United States, 1993. Morbidity and Mortality Weekly report.1995; 44:1-56).

(2) (Department of Health and Human Services. Healthy People 200:National Health Promotion and Disease Prevention Objectives. DHHS Publication No.91-50212. Washington DC:US Government Printing office;1990)

(3) (United Nations Declaration on the Rights of the child and United Nations General Assembly, Declaration of commitment on HIV/AIDS August 2nd 2001).

(4) Bandura, A. (1992) self – efficacy mechanism in psychobiologic functioning, self-efficacy: thought control of action pp.155-189 Washington: Hemisphere. Effective sex education develops young people’s skills in negotiation, decision-making, assertion and listening.

(5) Kirby, D., Barth, R., Leland, N. and Fetro, J (1991). Reducing the risk: a new curriculum to prevent sexual risk taking, Family planning perspectives 23 pp. 253-263.

(6) Kirby D, Short L, Collins J, etal. School based programs to reduce sexual risk behaviours: a review of effectiveness. Public Health Reports. 1994; 109:339-360

(7) DiClemente RJ, Durbin M, Siegal D, etal. Determinants of condom use among junior high school students in a minority, inner city school district, Paediatrics.1992; 89:197-202.

(8) Ubell E. Sex education programs that work and some that don’t. Parade Magazine. February 12, 1995:18-20

(9) Ehrhardt A. Sex education for young people. National AIDS bulletin. July 1993:32-35

(10) Dryfoos J. What the United States can learn about prevention of teenage pregnancy from other developed countries. SIECUS Reports. 1985; 17:1-7

(11) Kirby D, Barth R, Leland N, etal. Reducing the Risk: a new curriculum to prevent sexual risk taking. Family planning perspectives.1991;22:21-26.

(12) Howard M, Mccabe J. Helping teenagers postpone sexual involvement. Family Planning Perspectives.1990; 22:21-26.

 

 

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