Sex education is instruction on issues relating to human sexuality, including human sexual anatomy, sexual reproduction, sexual intercourse, reproductive health, emotional relations, reproductive rights and responsibilities, abstinence, birth control, and other aspects of human sexual behavior. Common avenues for sex education are parents or caregivers, formal school programs, and public health campaigns.

Overview

Human sexuality has biological, emotional/physical and spiritual aspects. The biological aspect of sexuality refers to the reproductive mechanism as well as the basic biological drive, Libido, that exists in all species, which is hormonally controlled. The emotional or physical aspect of sexuality refers to the bond that exists between individuals, and is expressed through profound feelings or physical manifestations of emotions of love, trust, and caring. There is also a spiritual aspect of sexuality of an individual or as a connection with others. Experience has shown that adolescents are curious about some or all the aspects of their sexuality as well as the nature of sexuality in general, and that many will wish to experience their sexuality.
Traditionally, adolescents were not given any information on sexual matters, with discussion of these issues being considered taboo. Such instruction as was given was traditionally left to a child's parents, and often this was put off until just before a child's marriage. Most of the information on sexual matters were obtained informally from friends and the media, and much of this information was of doubtful value. Much of such information was usually known to be deficient, especially during the period following puberty when curiosity of sexual matters was the most acute. This deficiency became increasingly evident by the increasing incidence of teenage pregnancies, especially in Western countries after the 1960s. As part of each country's efforts to reduce such pregnancies, programs of sex education were instituted, initially over strong opposition from parent and religious groups.
Burt defined sex education as the study of the characteristics of beings; a male and female.[1] Such characteristics make up the person's sexuality. Sexuality is an important aspect of the life of a human being and almost all the people including children want to know about it.[citation needed] Sex education includes all the educational measures which in any way may of life[clarification needed] that have their center on sex. He further said that sex education stands for protection, presentation extension, improvement and development of the family based on accepted ethical ideas. Leepson sees sex education as instruction in various physiological, psychological and sociological aspects of sexual response and reproduction.[2] Kearney also defined sex education as “involving a comprehensive course of action by the school, calculated to bring about the socially desirable attitudes, practices and personal conduct on the part of children and adults, that will best protect the individual as a human and the family as a social institution. Thus, sex education may also be described as "sexuality education", which means that it encompasses education about all aspects of sexuality, including information about family planning, reproduction (fertilization, conception and development of the embryo and fetus, through to childbirth), plus information about all aspects of one's sexuality including: body image, sexual orientation, sexual pleasure, values, decision making, communication, dating, relationships, sexually transmitted infections (STIs) and how to avoid them, and birth control methods.[3] Various aspect of sex education are to right[clarification needed] in school depending on the age of the students or what the children are able to comprehend at a particular point in time. Rubin and Kindendall expressed that sex education is not merely a unit in reproduction and teaching how babies are conceived and born. It has a far richer scope and goal of helping the youngster incorporate sex most meaningfully into his present and future life, to provide him with some basic understanding on virtually every aspect of sex by the time he reaches full maturity.[4]
Sex education may be taught informally, such as when someone receives information from a conversation with a parent, friend, religious leader, or through the media. It may also be delivered through sex self-help authors, magazine advice columnists, sex columnists, or sex education web sites. Formal sex education occurs when schools or health care providers offer sex education. Slyer stated that sex education teaches the young person what he or she should know for his or her personal conduct and relationship with others.[5] Gruenberg also stated that sex education is necessary to prepare the young for the task ahead. According to him, officials generally agree that some kind of planned sex education is necessary.[6]
Sometimes formal sex education is taught as a full course as part of the curriculum in junior high school or high school. Other times it is only one unit within a more broad biology class, health class, home economics class, or physical education class. Some schools offer no sex education, since it remains a controversial issue in several countries, particularly the United States (especially 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 sexual behavior, e.g. safe sex practices, masturbation, premarital sex, and sexual ethics).
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.[7] Leepson asserted that the majority of people favors some sort of sex instruction in public schools, and this has become an intensely controversial issue because unlike most subjects, sex education is concerned with an especially sensitive and highly personal part of human life. He suggested that sex education should be taught in the classroom.[2] The problem of pregnancy in adolescents is delicate and difficult to assess using sex education.[8] But Calderone[who?] believed otherwise, stating that the answer to adolescents' sexual woes and pregnancy can not lie primarily in school programmes which at best can only be remedial; what is needed is prevention education and as such parents should be involved.
When sex education is contentiously debated, the chief controversial points are 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.[9]
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.[citation needed] 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). The use of mass media campaigns, however, has sometimes resulted in high levels of "awareness" coupled with essentially superficial knowledge of HIV transmission.[10]
According to SIECUS, the Sexuality Information and Education Council of the United States, 93% of adults they surveyed support sexuality education in high school and 84% support it in junior high school.[11] In fact, 88% of parents of junior high school students and 80% of parents of high school students believe that sex education in school makes it easier for them to talk to their adolescents about sex.[12] Also, 92% of adolescents report that they want both to talk to their parents about sex and to have comprehensive in-school sex education.[13] Furthermore, a "...study, conducted by Mathematica Policy Research Inc. on behalf of the U.S. Department of Health and Human Services, found that abstinence-only-until-marriage programs are ineffective."[14]

Scientific studies

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.[15] 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.[16]
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 12–15 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)."[15]
Also, a U.S. review, "Emerging Answers", by the National Campaign To Prevent Teenage Pregnancy examined 250 studies of sex education programs.[18] The conclusion of this review was that "the overwhelming weight of evidence shows that sex education that discusses contraception does not increase sexual activity". The National Campaign published a follow up study in 2007 titled, "Emerging Answers 2007", reviewing fewer studies but confirming the original findings.[19] The 2007 study found that, "No comprehensive program hastened the initiation of sex or increased the frequency of sex, results that many people fear." Further, the report showed "Comprehensive programs worked for both genders, for all major ethnic groups, for sexually inexperienced and experienced teens, in different settings, and in different communities."

Public opinion studies

A survey conducted in Britain, Canada and the United States by Angus Reid Public Opinion in November 2011 asked adult respondents to look back to the time when they were teenagers, and describe how useful several sources were in enabling them to learn more about sex. By far, the largest proportion of respondents in the three countries (74% in Canada, 67% in Britain and 63% in the United States) said that conversations with friends were “very useful” or “moderately useful.” The next reputable source was the media (television, books, movies, magazines), mentioned by three-in-five Britons (65%) and Canadians (62%) and more than half of Americans (54%) as useful.
There are some striking differences on two other sources. While half of Canadians (54%) and Americans (52%) found their sex education courses at school to be useful, only 43% of Britons share the same view. And while more than half of Americans (57%) say conversations with family were useful, only 49% of Canadians and 35 per cent of Britons had the same experience.[20]

Sex education around the world

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 were undercut significantly by the Global Gag Rule, an initiative put in place by President Ronald Reagan, suspended by President Bill Clinton, and re-instated by President George W. Bush. The Global Gag Rule "...required nongovernmental organizations to agree as a condition of their receipt of Federal funds that such organizations would neither perform nor actively promote abortion as a method of family planning in other nations...."[21] The Global Gag Rule was again suspended as one of the first official acts by United States President Barack Obama.[22] The incidences of new HIV transmissions in Uganda decreased dramatically when Clinton supported a comprehensive sex education approach (including information about contraception and abortion).[23] According to Ugandan AIDS activists, the Global Gag Rule undermined community efforts to reduce HIV prevalence and HIV transmission.[24]
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).[citation needed] A coordinated program between UNDP, UNICEF, and the ministries of health and educa

Asia

The state of sex education programs in Asia is at various stages of development.

Thailand

Only in Thailand has there been progress on sex education, with the boundaries being pushed forward with each revision of the curriculum. Thailand has already introduced sexuality education. The first national policy on sexuality education in schools was announced in 1938, but sex education was not taught in schools until 1978. Then it was called “Life and Family Studies,” and its content consisted of issues related to the reproductive system and personal hygiene. The education curriculum has been revised several times, involving efforts from both government and non-government sectors and sex education has been accepted as a problem solving tool for adolescent SRH issues. This has been a consequence of educational reform following the National Education Act B.E. 2542, increasing awareness of problems related to adolescents’ sexual practices, and the emergence of women’s sexuality, and queer movements. Another new approach in sexuality education curricula in Thailand has been the Teenpath Project developed by PATH, Thailand. PATH has also succeeded in institutionalizing sexuality education curricula in schools since 2003.

India


Know Aids - No Aids road sign in Spiti Valley, Himachel Pradesh, India, 2010

AIDS Clinic, McLeod Ganj, Himachel Pradesh, India, 2010
In India, there are many programs promoting sex education including information on AIDS in schools as well public education and advertising. AIDS clinics providing information and assistance are to be found in most cities and many small villages.[25][26]
“India has a strong prevention programme which goes hand in hand with care, support and treatment. We have been able to contain the epidemic with a prevalence of just 0.31 %. We have also brought about a decline of 50% in new infections annually.” Shri Gulam Nabi Azad, Hon’ble Minister of Health and Family Welfare, 2011.[27]

Other countries

Indonesia, Mongolia, South Korea have a systematic policy framework for teaching about sex within schools. Malaysia and Thailand have assessed adolescent reproductive health needs with a view to developing adolescent-specific training, messages and materials.
(Bangladesh, Myanmar, Nepal and Pakistan have no coordinated sex education programs.[28])
In Japan, sex education is mandatory from age 10 or 11, mainly covering biological topics such as menstruation and ejaculation.[29]
In China and Sri Lanka, sex education traditionally consists of reading the reproduction section of biology textbooks. In Sri Lanka they teach the children when they are 17–18 years. 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 included discussion about sex within human relationships as well as pregnancy and HIV prevention.[30]
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.[31)

Europe

Morality

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.
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. Sex and relationship experts like Reid Mihalko of Reid About Sex suggests that open dialogue about physical intimacy and health education can generate more self-esteem, self-confidence, humor, and general health.[78]
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.[citation needed]
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 curricula based on abstinence.[79]

Lesbian, gay, bisexual, and transgender youth

In many countries, lesbians, gays, bisexual, transgender (LGBT) youth, and those with other sexual orientations or practices, are often ignored in sex education classes,[80] including a frequent lack of discussion about safer sex practices for manual, oral, and anal sex with regards to the different risk levels for contracting sexually transmitted diseases.

References

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