Too little, too late? Sexual Health Education for Youth

Youth sexual health education is an important topic requiring both effective timing and comprehension. According to the Centers for Disease Control and Prevention’s Division of Adolescent and School Health (DASH), sexual health education programs are more likely to delay initiation of sexual intercourse, decrease the number of sex partners, lower rates of unprotected sex, increase use of protection (specifically condoms), and improve academic programs1. However, controversies can arise between parents and faculty over curriculum content. Typical content can range from abstinence only, to promoting positive sexuality and acknowledging youth as sexual beings2. In 2018, the United Nations Educational, Scientific and Cultural Organization (UNESCO) released the latest international guidelines on sexual health education. Although the guidelines are a good step in the right direction, comprehensive and consistent sexual health education are still not reaching Canadian youth. Curriculum is dictated at a provincial level3, creating a divide in sexual health education across the country. Inconsistent sexual health education, lacking both comprehension and timing, may be putting youth more at risk. While one third of Canadian youth have had sexual intercourse before the age of 174, there is still a significant gap in youth’s knowledge of sexual health, including misconceptions surrounding STI’s and birth control use. Younger age groups also have an increasing prevalence of STI’s, especially between the ages of 15-292. In order to help decrease risky behaviour and improve overall health and well-being in youth, certain factors contributing to sexual health education need to be addressed. 

Comprehensive Content

Sexual health education often focuses solely on the biological aspects of sex, HIV, STI’s, and pregnancy. Nevertheless, studies have shown that many youth are dissatisfied with their sexual health education4. Their interests expand beyond biological aspects of sexual health like puberty, pregnancy, birth controls and STI’s, to topics like healthy relationships, sexual pleasure and communication strategies with partners4. But why is solely focusing on biological aspects of sexual health a problem? While such topics are important, the World Health Organization (WHO) emphasizes that sexual health extends beyond physical well-being and the absence of disease; it requires positive emotional, mental and social relations with sexuality and sexual relationships, and safe and pleasurable sexual experiences without coercion, discrimination and violence5. Comprehensive sexual health education decreases risky behaviour, increases knowledge of rights within sexual relationships, increases communication with parents, and gives greater self-efficacy to youth in risky situations6. Greater health and well-being has been linked to sexual satisfaction in partnerships, positive gender orientation or gender identity, improved communication skills and ability to access sexual health resources5.

Effective Timing

While governing organizations and educators are making an effort to effectively educate youth, sexual health education may not be introduced early enough into schools either. Up until 2018, Ontario’s 1998 health education curriculum introduced puberty and reproduction topics in grades 5 and 6, and topics surrounding sexuality first in grade 77. In one study, 24% of 13 year olds had never received sex education, but 5% of this age group had already engaged in sexual activity2. At the age of 13, youth are in grade 8. So if 13 year olds are already sexually active, relevant topics may not be targeting the correct age groups in order to promote safe and effective sexual behaviour. Youth lacking a comprehensive knowledge of sexual health are more prone to risk taking behaviours and increased risk of STI infection; for example, relationship abuse and violence can be strongly linked to gender roles and stereotypes6.

Updated and Relevant Content

It is extremely important that sex education is updated, culturally relevant and consistently reaching schools across Canada. Sexual health education has not been shown to increase sexual activity, risk-taking behaviour, or STI/HIV infection rates6. In fact, evidence shows that inclusive and culturally relevant sexual health education minimizes negative impacts including marginalization, HIV/STI vulnerabilities and reduces risk taking behaviours in youth3. Since 2019, the Canadian guidelines for sexual health5 have been updated in the effort to introduce more relevant and inclusive topics including:

  • changing demographics,
  • the process of reconciliation and the impact that colonialism has had on sexual health and wellbeing of Indigenous people,
  • the increasing use of technology, which changes how youth communicate about sexuality,
  • LBGTQI2S+ and other emerging identities, and providing relevant information like the diversity of sexual and gender expression,
  • and consent.
Increased Support for Educators

Educators and parents need additional support to ensure youth across the country are obtaining correct and consistent information. It was found that teachers lacking training in sexual health education often taught lessons solely within their comfort level3. Parents also felt unprepared to teach their children sexual health education as they themselves did not receive it growing up3. Parent child communication about sexuality at home can be critical, as sex negative messages and imposed control can put sexually active youth more at risk3. Increasing sexual health literacy could include increased supportive resources for effective communication and teaching strategies. A UNESCO study found that school based programs combined with community support including resource distribution, youth friendly services, and parents and teacher involvement were effective, especially for marginalized youth and those not in school6.

Parents, educators, and organizations creating sexual health policy need to work together to ensure youth are comprehensively educated in sexual health. Proper education decreases risky behaviour in youth, decreases their risk of acquiring STI’s and contributes positively overall to their health and wellbeing. These benefits will extend into the future as well, as youth will be more equipped to teach healthy, comprehensive and effective sexual health education when they become parents. So if these strategies can be implemented, youth will not only benefit from this education, but future generations will as well. 

Sources
  1. What Works: Sexual Health Education – https://www.cdc.gov/healthyyouth/whatworks/what-works-sexual-health-education.htm[]
  2. The Ontario Sexual Health Education Update: Perspective from the Toronto Teen Survey (TTS) Youth – https://cje-rce.ca/wp-content/uploads/sites/2/2017/07/Regular-2264-Larkin-July-4.Final_..pdf[][][]
  3. Sexual health education outcomes within Canada’s elementary health education curricula: A summary and analysis – https://www.utpjournals.press/doi/full/10.3138/cjhs.2018-0036[][][][][]
  4. Youth perspectives on sexual health education: Voices from the YEP study in Toronto – https://www.utpjournals.press/doi/pdf/10.3138/cjhs.2019-0049[][][]
  5. Canadian Guidelines for Sexual Health Education – http://sieccan.org/wp-content/uploads/2019/06/SIECCAN-Canadian-Guidelines-for-Sexual-Health-Education.pdf[][][]
  6. International technical guidance on sexuality education: an evidence-informed approach – https://unesdoc.unesco.org/ark:/48223/pf0000260770[][][][]
  7. The Ontario Sexual Health Education Update: Perspective from the Toronto Teen Survey (TTS) Youth – https://cje-rce.ca/wp-content/uploads/sites/2/2017/07/Regular-2264-Larkin-July-4.Final_..pdf[]

2 Comments

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I think your thoughts are spot on, and it’s interesting to hear from a young adult who has recently come through the education system and can reflect on those educational experiences. Beyond just the physiological education however, I also think that as a society, we would do well to include a large piece of education on relationships themselves. How we as human beings should treat one another, what is acceptable behaviour and what isn’t, a what to expect, and how we should treat each other. Stereotypical behaviour is still very prevalent, and whether you’re male or female, young people are learning about relationships from observing their own parents, or watching TV and if they’re lucky, they’ve got great role models to learn from.
If they’re learning from dysfunctional role models, then this sets a young person up for a potentially very challenging relationship road ahead.

Excellent article! I have often felt the sex education in schools has been lacking. A question that often arises: Is this for schools to teach or parents? In my opinion, if it is left to parents, healthy sexual education will not exist because old family habits and communication skills do not often change. We have seen this struggle in our own school where there are numerous parents that do not give permission for their children to attend the sexual education classes.
I think it is also important that there is more healthy relationship discussions in the sexual education curriculum as you mention. It is a confusing world out there with media and programs youth are watching that do not necessarily promote healthy relationships and therefore make it very confusing for our youth.
Where do we go from here? How can we make changes to help our youth grow up sexually and relationship healthy?

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