Sex education is a broad term used to describe education about human sexual anatomy, sexual reproduction, sexual intercourse, and other aspects of human sexuality. Common avenues for sex education are parents or caregivers, school programs, and public health campaigns. Almost all western countries have some form of sex education, but the nature varies widely. In some countries (such as Australia and much of Europe) "age-appropriate" sex education often begins in pre-school, whereas other countries (notably the United States) leave sex education to the teenage years and even the late teenage years.
The world's major religions concur in viewing sexual intimacy as proper only within marriage; otherwise it can be destructive to human flourishing. There are a great many forms of human sexuality, comprising a broad range of behaviors, and sexual expression varies across cultures and historical periods. Yet the basic principles of human sexuality are universal and integral to what it means to be human. Sex is related to the very purpose of human existence: love, procreation, and family. Sexuality has social ramifications; therefore most societies set limits, through social norms and taboos, moral and religious guidelines, and legal constraints on what is permissible sexual behavior. Sex education aims to educate and inform young people about these norms.
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 (such as "safe sex" practices, masturbation and sexual ethics).
In the United States in particular, sex 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 STDs. 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 United States) have a higher incidence of STDs and teenage pregnancy.
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 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.
Sex education is fairly common in the United States. Most public schools are required to offer a health class to students. The first year of this class varies from as early as elementary school through high school. The purpose of this class is education regarding general health and in later years a focus on sex education. Though often a requirement for graduation, many states allow parents to "opt out" or not have their children take the class. Curriculum in these classes often includes an introduction to contraceptives, basic human anatomy, and discussions of romantic relationships.
Some advocates have successfully worked toward the introduction of "abstinence-only" curricula. Under such instruction, teens are told that they should be sexually abstinent until 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 STIs.
In December 2004, United States Congressman Henry A. Waxman of 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 about sexuality.
In 2007, a study ordered by the United States Congress found that middle school students who took part in abstinence-only sex education programs were just as likely to have sex in their teenage years as those who did not. The study followed more than 2,000 students from age 11 or 12 in 1999 to age 16 in 2006. It included those who had participated in one of four abstinence education programs as well as a control group who had not. By age 16, about half of each group—participants in an abstinence-only program as well as the control group—were still abstinent. Abstinence program participants who became sexually active during the study period reported having similar numbers of sexual partners as their peers of the same age, and first had sex at about the same age as other students. The study also found that students who took part in the programs were just as likely to use contraception when they did have sex as those who did not participate.
In England, 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.
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.
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 is 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.
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 16 years. These are included as subjects in the curriculum and generally involves open and frank interaction with the teachers. Bangladesh, Myanmar, Nepal, and Pakistan have no coordinated sex education programs.
The International Planned Parenthood Federation and the BBC World Service ran a 12-part series which discussed sex education, family life education, contraception, and parenting. It was first launched in South Asia and then extended worldwide.
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.
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.
One approach to sex education is to view it as necessary to reduce risk behaviors 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 is not 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 political 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 religious conservatives believe that sexuality is a subject that should not be taught at all. They believe that the longer a teenager is kept unaware of sexuality, the less likely they will become involved in sexual behavior. Conservative religions believe that sexual behavior outside of marriage is immoral. Other religious conservatives believe that sexual knowledge is unavoidable, and so desire to teach curricula based on abstinence.
For others, teaching about human sexuality is inextricably linked to morality:
Sex education is ... about character and formation of character. A sex education in which issues of right and wrong do not occupy center stage is evasive and irresponsible.
Thomas Lickona advocates character education in schools as the remedy for a society nearly bereft of character, and proposes that the solution is to awaken children's social consciences:
The disturbing behaviors that bombard us daily-violence, greed, corruption, incivility, drug abuse, sexual immorality, and a poor work ethic-have a common core: the absence of good character.
Lickona and others have found that it not information that determines the choices young people make, but rather values. Abstinence-oriented programs that are character-based, and inclusive of not only peers at school, but family and community are more effective.
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 LGB and Transgender 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.
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. Their review of several studies showed 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 percent in the partners of men and 46 percent in women (confidence interval 0.95 to 2.25 and 0.98 to 2.26 respectively). The researchers concluded:
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.
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 United States review, "Emerging Answers," by the National Campaign To Prevent Teenage Pregnancy examined 250 studies of sex education programs. The conclusion of this review noted:
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.
Successful programs, such as Free Teens, generate positive peer pressure by involving older students as mentors and teachers, and encouraging the establishment of student clubs which seek to increase the number of teens aware of the consequences of risky behavior such as uncommitted sex and drugs and who have resolved to abstain from sex, drugs, and other high-risk behaviors. A focus on the positive aspects of abstinence, such preparing for a committed love relationship that can last a lifetime, is the hallmark of such efforts.
All links retrieved December 22, 2007.
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