Comprehensive sex education
Comprehensive Sexuality Education (CSE) is a sex education instruction method based on a curriculum that aims to give students the holistic knowledge, attitudes, skills, and values to make healthy and informed choices in their sexual lives. The intention is that this understanding will help students understand their body and reproductive processes, engage in safer sex by reduce incidents of contracting sexually transmitted infections (STIs) such as HIV and HPV, reduce unplanned and unwanted pregnancies, as well as lowering rates of domestic and sexual violence.[1]
CSE curricula covers a wide range of topics relating to sexual and reproductive health and rights. Curriculums regarding sexual behavior differs based on the audience, but typically includes age-appropriate information[2] on puberty, adolescence, sexual intercourse, and age of consent. This includes promoting safe sexual behaviors, such as using correct birth control and contraception, communicating with partners, and seeking testing for STIs. Additionally, CSE curricula may discuss pregnancy outcomes such as maternal health, parenting, adoption, and abortion. CSE curricula are now also giving importance to including information sexual orientation, gender identity and expression, and sex characteristics.[3][4][5][6][7][8][9]
Some states have introduced bills that would require all pre-existing sex education curricula in public schools to be fully comprehensive and inclusive. The most widely agreed benefit of using comprehensive sexuality education over abstinence-only sex education is that CSE acknowledges that young people will be sexually active in their future. By acknowledging this, CSE can encourage students to plan ahead to make the healthiest possible sexual decisions. This ideology of preparing students for safe future sexual experiences underlies the majority of topics within CSE, including various methods of contraception and refusal skills.
History[edit]
As of 2019, sex education in the United States is mandated at the state level, with individual states, districts, and school boards responsible for determining the implementation of federal policy and funds for sex education. Currently, 24 out of the 50 U.S. states and the District of Columbia mandate general sex education, while 34 states mandate HIV education. Notably, in states where sex education is mandated, there is no federal policy requiring the instruction of comprehensive sex education.
During the George W. Bush administration, conservative Republicans in Congress strongly supported abstinence-only-until-marriage sex education. Conversely, under the Barack Obama administration, there was opposition to abstinence-only education, with suggestions to eliminate it. With advent of President Trump's administration, the federal agenda reverted back to supporting an abstinence-based approach.
According to the 2014 School Health Places and Practices Study conducted by he Centers for Disease Control and Prevention, high school courses, on average, dedicate 6.2 hours of class time to human sexuality, with a notable emphasis on abstinence. However, the same study found that 4 hours or less are typically allocated to topics such as HIV, other sexually transmitted infections and pregnancy prevention.
Criticism[edit]
Comprehensiveness[edit]
While CSE implementation is on the rise in the United States, it remains difficult for state officials to regulate what is and is not taught in the classroom. This is due in large part to the undefinability of CSE; CSE has the potential to comprise such a wide range of sexual information, and over-all focus varies widely between curricula.[30] Educators have also accused CSE of fundamentally operating as a form of "abstinence-plus", due to the reality that CSE often involves minimal body-related information and excessive promotions of abstinence.[31] "So-called Comprehensive Sex Ed" says Sharon Lamb, a professor at the University of Massachusetts Boston, "has been made less comprehensive as curricula are revised to meet current federal, state, and local requirements."[31]
The Healthy Youth Act Massachusetts[edit]
Overview[edit]
An Act Relative to Healthy Youth, or the Healthy Youth Act, is a bill (HD.3454/SD.2178) that would require any public school in Massachusetts with a sex education curriculum to be fully comprehensive. This would include materials that are age-appropriate, medically-accurate, LGBTQ-inclusive, and consent-focused. Content would address how to build healthy relationships and how to prevent pregnancy and STIs when a person does have sex. The Healthy Youth Act was initially filed in January 2011 and has been revised multiple times since. This bill is a framework that does not mandate a particular curriculum, but does require that schools where sex education is already being taught fit this framework. Parents will be given 30 days-notice to review the material and opt-out.
In 2021, the Healthy Youth Act was cosponsored by Senator Sal N. DiDomenico and Representatives Christina A. Minicucci, Vanna Howard, and Jack Patrick Lewis of the 192nd General Court of the Commonwealth of Massachusetts. Bill SD.2178 has been advocated for over 10 years and has successfully passed the Massachusetts Senate, however it has yet to be passed by the Massachusetts House of Representatives.
Controversy[edit]
Reactions to the Healthy Youth Act have been mixed, but it has gained increased support over the years. Some of its most dedicated supporters include Fenway Health, the Healthy Youth Coalition, The Massachusetts Healthy Youth Consortium, and Getting to Zero. The Planned Parenthood League of Massachusetts states that "comprehensive sex education is about more than just sex – it helps creates a culture of consent, recognizes and prioritizes LGBTQ youth health needs, and gives young people the tools to build healthy relationships... We can combat sexual assault at its roots by teaching young people how to build healthy, respectful relationships". In 2018, a poll of Massachusetts residents showed that 92% of people agree that students should receive comprehensive sex education in high school. In a testimony in support of the bill, supporters claim that "sex education is a perfect opportunity for youth to develop skills like communication, healthy relationships, decision-making, planning, and critical thinking. Such life skills can contribute to their positive development throughout adolescence and into adulthood".
The Massachusetts Family Institute (MFI), a conservative organization that promotes traditional Judeo-Christian values and the bill's main opponent, highlights the article "Pornographic 'Comprehensive Sexuality Education' in Massachusetts Public Schools" on the front page of their website. This article refutes Planned Parenthood's claims, stating that "it’s no wonder that Planned Parenthood is pushing it in our schools. Planned Parenthood administrators know that if they sexualize young people, they will create new customers who seek out their abortion services, sexually transmitted infection treatments, and transgender hormone therapies". Instead, MFI argues that the Healthy Youth Act would inappropriately expose underaged youth to "pornographic" content that would encourage youth to engage in sexual behaviors, concluding that "state education officials and local school administrators ought to reject Comprehensive Sexuality Education as the poisoner of children that it is".
Sexual Risk Avoidance (SRA) curricula has been promoted in direct opposition to the Healthy Youth Act. Advanced by Ascend, this curricula promotes an abstinence-only approach to sex education. Within SRA education programs "Ascend works with SRA educators, community organizations and more as they educate youth using a primary prevention health model".
The Healthy Youth Act California[edit]
Overview[edit]
The Healthy Youth Act in California, a department of Education mandate on January 1, 2016, requires school districts to provide students with integrated, comprehensive, accurate and comprehensive health and HIV prevention education from trained instructors at least once in middle school and once in high school.[44]
The purpose of the act is to provide comprehensive, accurate and unbiased sexual health and HIV prevention education.[45]
Preventive education must meet all requirements of the law except for the requirements for specific contents of grades 7 to 12. All "education on human development and gender, including education on pregnancy, contraception and venereal diseases" (EC 19 51931(b) is by definition a comprehensive sexual health education and should be satisfied, regardless of what schools call it by name. HIV prevention education is defined as "the nature of HIV and AIDS, the methods of transmission, strategies to reduce the risk of HIV infection, and guidelines for social and public health issues related to HIV and AIDS" (EC 551931(d).[45]
Purpose[edit]
The law has five main objectives:
As a human right[edit]
Some critics state that young people's access to CSE is grounded in internationally recognized human rights, which require governments to guarantee the overall protection of health, well-being and dignity, as per the Universal Declaration on Human Rights, and specifically to guarantee the provision of unbiased, scientifically accurate sexuality education.[21]
These rights are protected by internationally ratified treaties, and lack of access to sexual and reproductive health (SRH) education remains a barrier to complying with the obligations to ensure the rights to life, health, non-discrimination and information, a view that has been supported by the Statements of the Committee on the Rights of the Child, the Convention on the Elimination of all Forms of Discrimination Against Women (CEDAW) Committee, and the Committee on Economic, Social and Cultural Rights.[21]
The commitment of individual states to realizing these rights has been reaffirmed by the international community, in particular the Commission on Population and Development (CPD), which – in its resolutions 2009/12 and 2012/13 – called on governments to provide young people with comprehensive education on human sexuality, SRH and gender equality.[21]
Other analysis show that comprehensive sex education is not an international right nor a human right because it not clearly stated in either a treaty or custom. By international law, states are required to provide access to information and education about reproductive health, but this does not require a sex education curriculum. It may take different forms such as mandating that local school districts create a system for providing information to students, or mandating that health clinics and practitioners dispense information to patients.[35]
In curricula[edit]
Teaching methods[edit]
As CSE gains momentum and interest at international, regional and national levels, governments are increasingly putting in place measures to scale-up their delivery of some form of life skills-based sexuality education, as well as seeking guidance on best practice, particularly regarding placement within the school curriculum. Sexuality education may be delivered as a stand-alone subject or integrated across relevant subjects within the school curricula. These options have direct implications for implementation, including teacher training, the ease of evaluating and revising curricula, the likelihood of curricula being delivered, and the methods through which it is delivered.[21]
Within countries, choices about implementing integrated or stand-alone sexuality education are typically linked to national policies and overall organization of the curricula. The evidence base on the effectiveness of stand-alone vs. integrated sexuality education programming is still limited. However, there are discernible differences for policy-makers to consider when deciding the position of CSE within the curriculum.[21]
As a stand-alone subject, sexuality education is set apart from the rest of the curriculum, whether on its own or within a broader stand-alone health and life skills curriculum. This makes it more vulnerable to potentially being sacrificed due to time and budget constraints, since school curricula are typically overcrowded.[21]
However, a stand-alone curriculum also presents opportunities for specialized teacher training pathways, and the use of non-formal teaching methodologies that aim to build learners' critical thinking skills. The pedagogical approaches promoted through sexuality education – such as learner-centred methodologies, development of skills and values, group learning and peer engagement – are increasingly being recognized as transformative approaches that impact on learning and education more widely. As a standalone subject, it is also significantly easier to monitor, which is crucial in terms of evaluating the effectiveness of programming, and revising curricula where it is not delivering the desired learning outcomes.[21]
When sexuality education is integrated or infused, it is mainstreamed across a number of subject areas, such as biology, social studies, home economics or religious studies. While this model may reduce pressure on an overcrowded curriculum, it is difficult to monitor or evaluate, and may limit teaching methodologies to traditional approaches.[21]
Terminology[edit]
Apart from the different teaching methods, terminology also differs. Abortion, homosexuality, abstinence have connotations and definitions that vary state. For example, the word "abstinence" may refer to disengaging from all forms of sexual activities until marriage or may refer to only disengaging from sexual intercourse. Furthermore, the degree of sexual activity that "abstinence" connotes is often unclear, because sexual behavior that is not sexual intercourse may or may not be included in its definition. As a result, students are left confused about what activities are risky and teachers do not know what they can and cannot teach.
The term "comprehensive", is also falls on spectrum, therefore can be considered an umbrella term. CSE means something radical for some institutions while it can mean something moderate and even conservative for others.[30]
According to the Sexuality Information and Education Council of the United States (SIECUS), the guidelines for comprehensive sexuality education are as follows:[47]
Sexual content in the media[edit]
Since 1997, the amount of sexual content on TV has nearly doubled in the United States.[48] Additionally, a study done in 2008 showed that nearly 40% of popular music lyrics contained sexual references which were often sexually degrading. These lyrics were also often accompanied with mentions of other risk behaviors, such as substance use and violence.[48]
Teens (ages 13–15) in the United States, use entertainment media as their top source for education in regards to sexuality and sexual health. Additionally, a study found that 15–19-year-olds in the U.S use media far more than parents or schools to obtain information about birth control.[48] Some studies have found that, "very few teen television shows mention any of the responsibilities or risks (e.g., using contraception, pregnancy, STIs) associated with sex and almost none of the shows with sexual content include precaution, prevention, or negative outcomes as the primary theme."[48] Television shows 16 and Pregnant and its spin-off, Teen Mom, which first aired on MTV in 2009 received major disapproval from some parents as they thought the shows glamorized teen pregnancy and motherhood. However, 16 and Pregnant actually led to a 4.3 percent reduction in teen pregnancy, mostly as a result of increased contraceptive use.[10] In contrast, other data shows that exposure to high levels of sexual content on the television causes adolescents to have twice the risk of becoming pregnant in the following three years, compared to those who were exposed to low levels.[48]
The film Mean Girls, directed by Mark Waters shed light on the state sex education in some parts of the United States. In the film the health instructor states, "At your age, you're going to have a lot of urges. You're going to want to take off your clothes and touch each other. But if you do touch each other, you will get chlamydia and die." This line is meant to be satirical, but it illustrates common flaws within sex education in the U.S. It depicts simplistic descriptions of sexual activity and implementation of fear without any legitimate basis.[10]
Comprehensive sex education is the main topic in the documentary The Education of Shelby Knox (2005) about Lubbock, Texas, which has one of the highest teen pregnancy and STD rates in the nation; the "solution" to which is a strict abstinence-only sex education curriculum in the public schools and a conservative preacher who urges kids to pledge abstinence until marriage.
In 2013, How to Lose Your Virginity was released, a documentary that questioned the effectiveness of the abstinence-only sex education movement and observed how sexuality continues to define a young woman's morality and self-worth.[49][50] The meaning and necessity of virginity as a social construct is also examined through narration and interviews with notable sexuality experts, such as former Surgeon General Joycelyn Elders, "Scarleteen"[51] creator and editor Heather Corinna, historian Hanne Blank, author Jessica Valenti, and comprehensive sex education advocate Shelby Knox.
Not only have films portrayed sex education, but so has social media. Platforms such as YouTube, Facebook, and others are used as a tool to uplift the narratives of marginalized communities such as persons of color and LGBT persons in hopes to "strengthen sexual health equity for all."[41]
As a result of the mass amount of sex content in media, media literacy education (MLE) has emerged. It was created to address the influence of unhealthy media messages on risky health decisions, such as intention to use substances, body image issues, and eating disorders.[48] A study analyzed the effectiveness of a teacher-led MLE program, called Media Aware Sexual Health (MASH), which provides students with accurate health information and teaches them how to apply that information to critical analysis of media messages. This comprehensive sex education resulted in increased intentions to talk to a parent, partner and medical professional prior to sexual activity, and intentions for condom use.[48]
Due to knowledge gaps in most sex education curricula for teens, free online resources like Sex, Etc., Scarleteen.com, and teensource.org[52] have been created to promote comprehensive, inclusive, and shame-free sex education for teenagers.
Sources[edit]
This article incorporates text from a free content work. Licensed under CC-BY-SA IGO 3.0 (license statement/permission). Text taken from Emerging evidence, lessons and practice in comprehensive sexuality education: A global review 2015, 14, 15, 25, 29, UNESCO, UNESCO. UNESCO.