Sex education

Sex education is education about sexual behaviour (including sexual intercourse) and sexual reproduction in human beings, including the development of the embryo and fetus from conception to birth. It often includes topics such as sexually transmitted diseases and how to avoid them, as well as methods of contraception.

Although some sort of sex education is part of many schools' curricula, 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.

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 pandemic 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.

Morality of sex education

One liberal 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. A more common approach to sex education is to view it as necessary to reduce risk behaviors such as unprotected sex, but these views sometimes go hand in hand. Additionally, proponents of comprehensive sex ed contend that education about homosexuality encourages tolerance, but does not "turn students gay" as some conservatives believe.

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 some preconceived notion 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.

Debate in the United States

Most parents in the U.S. feel that teenagers should remain sexually abstinent, but should have access to contraception. Ninety-five percent of adults in the United States and 85 percent of teenagers think it's important that school-aged children and teenagers be given a strong message from society that they should abstain from sex until they are out of high school. Almost 60 percent of adults also think that sexually active teenagers should have access to contraception. (Source: The National Campaign to Prevent Teen Pregnancy (http://www.teenpregnancy.org/genlfact.htm)). A 1997 study found that about 48 percent of high school students are sexually active.

In the United States, 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 adulthood and/or marriage, and information about contraception is not provided. Opponents argue this approach denies teens needed, factual information and could lead to unwanted pregnancies and propagation of STDs.

Some curricula are advocated on the grounds that they are intended to reduce sexual disease or out-of-wedlock pregnancy, but it is rare for a curriculum to be tested as to whether it is effective in its aims. A curriculum ostensibly aimed at reducing out-of-wedlock pregnancy among high school students, which advocates the use of condoms, could potentially lower or raise the pregnancy rate. A successful curriculum could be adopted by other districts. Proponents of this view argue that 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 hold that conventional or conservative moralizing will put off students and thus weaken the message.

In turn, opponents object that curricula which fail to teach moral behavior 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 contructive", and that value-free knowledge of the body may lead to unhealthy and harmful practices. If the curricula really had a practical intent, critics maintain, school districts would drop those which were ineffective in favor of effective ones.

Scientific study of sex education

The debate over teenage pregnancies 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 [1]. Their review of several studies shows that abstinence-only programs not only did not reduce the likelihood of pregnancy in partners of men who participated in the programs or in women who did, but that they 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 and Visser have published an analysis of ­ associated factors. In contrast, the rates are 93 per 1000 in the United States, 62.6 per 1000 in England and Wales, and 42.7 per 1000 in Canada. 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). [footnotes omitted]

Also, in answer to the criticism of conservatives, a US review, "Emerging Answers", by the National Campaign To Prevent Teen Pregnancy examined 250 studies of sex education programs [2]. 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 underway 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 (see sexual abstinence).

References and external links

1. DiCenso A. et al.: Interventions to Reduce Unintended Pregnancies Among Adolescents: Systematic Review of Randomized Controlled Trials. British Medical Journal 2002;324:1426. Online copy. (http://press.psprings.co.uk/bmj/june/gp1426.pdf)
2. 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. (http://www.teenpregnancy.org/resources/data/report_summaries/emerging_answers/default.asp)

See also:

• Sexual morality