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Helping Sexually Confused Teens One Lesson at a Time: An Argument for Sexuality Education


By: Amani Echols


Can you imagine a high school in which teens pay to confess their sexual and relationship dysfunctions to a peer, despite the gossipy nature of high school and their persistent need to seem sexually experienced? This is exactly what happens in Netflix’s British comedy show Sex Education, featuring a socially awkward 16-year-old high school student named Otis. Although Otis is inexperienced with sex and relationships, he is much more knowledgeable than his peers due to the fact that his mom is a sex therapist. Otis’ home life resembles one long sex education course: his mom has surrounded him with videos, manuals, and explicit, open conversations about sex 24/7. When Otis’ classmates learn about his knowledge of sex and relationships, he teams up with another student to run a profitable underground sex therapy clinic at school. As the school’s new “sex guru,” Otis advises classmates on their most intimate issues, ranging from improving relationship communication to encouraging a female peer to explore what brings her pleasure when having sex by masturbating.


What makes Sex Education so refreshing is that it not only provides an analysis of teenage sexuality through the lens of Otis, but also presents sexual and gender fluidity that is lacking in mainstream television. For example, we watch Otis’ best friend Eric express his sexuality through his wardrobe as he gains more confidence as the season progresses. Similarly, we see Otis’ date to the prom, a short-haired girl, dress in a tuxedo. Moreover, through the extreme scenario of teens paying for sex advice from a peer, the series showcases the need for greater sexual education among adolescents. The major gaps in knowledge experienced by the high-schoolers concerned relationship communication, expression of love and affection, sex, sexual pleasure, masturbation, body image, and self-esteem.


THE UNITED STATES’ MODEL OF SEX EDUCATION

Sex education in schools is important because, at least in theory, it informs students about healthy relationships, granting them the in-depth knowledge needed to provide informed consent; and it promotes bodily autonomy and integrity. As exhibited in Sex Education, the existing sex education systems in many countries do not address the needs and concerns of students or inform them of basic sexual health knowledge and skills. In the U.S., there is no federal policy that requires sexual education in schools. Only half of U.S. states (24 states and D.C.) have enacted policies that mandate sex education in public schools, and the comprehensiveness and accuracy of the curricula vary (Guttmacher Institute, 2019). This means that a huge portion of America's youth may not know what constitutes safe sex. Twenty-seven states and D.C. mandate that if sex education is taught, the curriculum must meet certain general requirements (Guttmacher Institute, 2019).

Of these 27 states:


26 states and D.C. require that the information be age appropriate, meaning the curriculum aligns with the social, cognitive, and emotional experience and developmental level of the students (Oregon Department of Education, n.d.).

13 states require the information to be medically accurate.


8 states require the program to be culturally appropriate and not be biased against any race, sex or ethnicity.


2 states prohibit the promotion of religion.


10 states and D.C. mention the terms “healthy relationships,” “sexual assault,” or “consent” in their sex education programs, which limits students’ ability to identify healthy and unhealthy relationship behaviors in most states (Shapiro and Brown, 2018).

The following maps provide additional information on the sex education disparities and lack of sex education standards in the U.S.


Image provided by The Huffington Post and data collected by the Guttmacher Institute (Klein, 2014)

This lack of sex education is reflected in the United States’ poor sexual health status. The U.S. consistently falls below other industrialized nations in sexual health indicators, such as teen pregnancy, STIs, positive experiences with sex, contraception use, and abortion (Weaver, Smith, & Kippax, 2005). For example, although teen pregnancy has decreased nationally over the years, the U.S. still has the highest teen birth rate in the industrialized world—approximately one in four girls will become pregnant at least once before their twentieth birthday (NCSL, 2016). Additionally, U.S. teens are disproportionately impacted by STIs. In fact, adolescents aged 15 to 24 only represent 25% of the sexually active population but acquire half of all new STIs, amounting to 9.8 million new cases annually (NCSL, 2016). In addition, the 2015 National Youth Risk Behavior Survey revealed that 12% of high school females reported physical violence and nearly 16% reported sexual violence from a dating partner in the last 12 months (CDC, 2018). In the wake of the #MeToo and Time’s Up movements, it is important to interrogate the current way children are (and are not) taught about gender and sexual identity in schools in addition to safe sex and healthy relationship skills, and look to other countries for models that work.


THE NETHERLANDS’ MODEL OF SEX EDUCATION

The Netherlands provides a progressive and comprehensive alternative to the United States’ current failing model of sexual education. Their curriculum starts in elementary school and covers a breadth of topics, emphasizing young people’s rights, responsibilities, and respect. By law, the Netherlands mandates that all primary school students must receive some type of comprehensive sexuality education. The Netherlands requires sexuality education because they define their goals as bigger than sexual education alone. Sexuality encompasses various topics, like self-image, developing your own identity, gender roles, and learning to express yourself, your wishes and your boundaries (de Melker, 2015; Haberland and Rogow, 2015; European Expert Group on Sexuality Education, 2016). The Netherlands begins its sex education curriculum at as early as four years old. Sex is not explicitly mentioned at this age; rather, the lessons focus on body awareness and getting the kindergartners to be able to communicate when they do not want to be touched (see video) (de Melker, 2015). This is an important lesson for addressing child sexual abuse and violence. Additionally, children are not separated by gender to explore these topics, which often happens in American schools. Moreover, evidence supports that starting sex ed in elementary school helps avoid unintended pregnancies, maternal deaths, unsafe abortions, and STIs (Igras, Macieira, Murphy, & Lundgren, 2014).


By age seven, kids in the Netherlands are expected to be able to accurately name body parts including genitals. At eight years old, students learn about self-image and gender stereotypes, and by age eleven, students discuss sexual orientation and contraceptive options with the goal of being comfortable enough to navigate pointed discussions about reproduction, safe sex, and sexual abuse (see video) (de Melker, 2015). Pre-adolescence (4th and 5th grade) marks a critical transition between childhood and adolescence and adulthood, which sets the stage for future sexual health and gendered attitudes and behaviors. As such, targeted investment at this age is imperative to lay the foundations for healthy future relationships and positive sexual and reproductive health (Igras, Macieira, Murphy, & Lundgren, 2014).


The Netherlands’ curriculum prioritizes inclusivity and fostering open, honest conversations about love and relationships. The sexuality education system in the Netherlands allows for flexibility in how the curriculum is taught, but a few core principles are required. Of these principles, sexual diversity and sexual assertiveness are included to encourage respect for all sexual preferences and to help students develop skills for protecting against sexual coercion, intimidation, and abuse (de Melker, 2015). The Netherlands’ sexuality education teaches the youth to be inclusive of individuals’ sexual preferences and aware of their own and others’ bodily autonomy, which helps to create positive sociocultural norms surrounding gender and sexuality equality.


OUTCOMES OF THE AMERICAN AND DUTCH SEX EDUCATION MODELS

The difference in the health effects of these two very different approaches to sex education is profound. In contrast to the United States’ sexual health ranking, the Netherlands is one of the top ranking westernized countries in sexual health, noted by the country’s low rates of teen pregnancy and high contraceptive use among young people (Weaver, Smith, & Kippax, 2005; Ferguson, Vanwesenbeeck, & Knijn, 2008). A study assessing differences in sexual health behaviors and outcomes between heterosexually active male college students in the U.S. and the Netherlands found that American men were more likely to report HIV and STIs, inadequate contraception, and unintended parenthood than were Dutch men (Dodge, Sandfort, Yarber, & De Wit, 2005). In the Netherlands, among 12 to 25-year-olds, most say that they had “wanted and fun” first sexual experiences, whereas 66% of sexually active American teens surveyed said they wished that they had waited longer to have sex for the first time (de Melker, 2015). Moreover, dispelling the common myth that comprehensive sexual education promotes promiscuity, teens in the Netherlands and the U.S., on average, start having sex at the same age (de Melker, 2015). Furthermore, when teens did have sex for the first time in the Netherlands, nine out of ten adolescents used contraceptives and are among the top users of the birth control pill globally (de Melker, 2015). Only 60% of American teens reported condom use and only 23% reported birth control pill use during their last sexual encounter in a CDC survey (NCSL, 2016). In addition, the teen pregnancy rate among the Dutch is one of the lowest in the world and five times lower than the United States. Rates of HIV infection and STDs are also remarkably low, especially compared to the United States (de Melker, 2015).


The lack of comprehensive and accurate sexual health education in the U.S. is a major public health concern, contributing to the country’s poor sexual health status compared to other industrialized countries. Poor sexual education is a vicious cycle in which uneducated, self-conscious adults are unable to have open conversations with children and young people about love, sex, and relationships. (For this reason, schools in the Netherlands aim to educate parents too and provide them with the tools needed to educate their children). The U.S. should provide comprehensive and accurate sexuality education in all K-12 public schools (and schools that receive any type of government funding) to improve adolescent and adult sexual health. Mandated sexuality education would provide young people with the knowledge, skills, and values needed to have healthy, enjoyable sexual lives and informed healthy decision making. Moreover, sexuality education goes a step further by including conversations of inclusivity, gender fluidity, sexuality, and body image.


MOVING FORWARD

Most importantly, the U.S. must provide an education that precipitates a radical cultural shift, challenging the status quo which normalizes and perpetuates sexism, hegemonic masculinity, and homophobia. To accomplish this, the U.S. sex education system must transition away from providing a morally-focused, abstinence-until-marriage curriculum, which is often based upon fundamentalist Christianity, because it has consistently proven to be ineffective in improving knowledge, attitudes, behaviors and outcomes related to sexual health (Carroll, 2017; Denford, Abraham, Campbell, & Busse, 2017). As demonstrated in Sex Education, teens will have sex no matter what—in the words of Otis’s best friend, Eric, everyone is “either thinking about shagging, about to shag, or actually shagging,” (Nunn, 2018). Knowing that adolescents are sexually active, it is our ethical duty as a country to educate them to express their sexuality safely and enjoyably. Furthermore, while advising his classmates on sex and relationships, Otis often encourages his peers to fully explore their bodies, sexualities, and emotions. In his words, “everyone has bodies, right? There is nothing to be ashamed of,” (Nunn, 2018). We all have our own sexual journeys and we ought not to compare our paths to others. It is important that all children and adolescents hear this message. To achieve this, the U.S. government must adopt evidence-based, sex-positive government policies that seek to empower youth. Though not a perfect system, the Netherlands’ model exemplifies effective comprehensive K-12 sexuality education; a similar curriculum should be adapted to reflect the country’s diverse population, and applied in the United States.



References

Carroll, A. (2017). Sex Education Based on Abstinence? There’s a Real Absence of

Evidence. Retrieved from https://www.nytimes.com/2017/08/22/upshot/sex-education-based-on-abstinence-theres-a-real-absence-of-evidence.html

de Melker, S. (2015). The case for starting sex education in kindergarten. Retrieved

from https://www.pbs.org/newshour/health/spring-fever

Denford, S., Abraham, C., Campbell, R., & Busse, H. (2017). A comprehensive review

of reviews of school-based interventions to improve sexual-health. Health psychology review, 11(1), 33-52.

Dodge, B., Sandfort, T. G., Yarber, W. L., & De Wit, J. (2005). Sexual health among

male college students in the United States and the Netherlands. American journal of health behavior, 29(2), 172-182.

European Expert Group on Sexuality Education. (2016). Sexuality education–what is

it?. Sex Education, 16(4), 427-431.

Ferguson, R., Vanwesenbeeck, I., & Knijn, T. (2008). A matter of facts… and more: an

exploratory analysis of the content of sexuality education in The Netherlands, Sex Education, 8(1), 93-106, DOI: 10.1080/14681810701811878

Guttmacher Institute. (2019). Sex and HIV Education. Retrieved from

https://www.guttmacher.org/state-policy/explore/sex-and-hiv-education

Haberland, N., & Rogow, D. (2015). Sexuality education: emerging trends in evidence

and practice. Journal of adolescent health, 56(1), S15-S21.

Igras, S., Macieira, M., Murphy, E., & Lundgren, R. (2014). Investing in very young

adolescents' sexual and reproductive health, Global Public Health: An International Journal for Research, Policy and Practice, 9(5), 555-569, DOI: 10.1080/17441692.2014.908230

Klein, R. (2014). These Maps Show Where Kids In America Get Terrifying Sex Ed. The

Huffington Post. https://www.huffpost.com/entry/sex-education-requirement-maps_n_5111835

National Conference of State Legislatures [NCSL]. (2016). State Policies on Sex

Education in Schools. Retrieved from http://www.ncsl.org/research/health/state-policies-on-sex-education-in-schools.aspx

Nunn, L. (Creator). 2018. Sex Education. Netflix Studios and Netflix Global,

https://www.netflix.com/title/80197526

Oregon Department of Education. (n.d.). Health and Sexuality Education Standards in

Oregon. https://www.oregon.gov/ode/students-and-family/healthsafety/Documents/Oregon%20CSE%20Summary%202018.pdf

Shapiro, S. & Brown, C. (2018). Sex Education Standards Across the States. Retrieved

from https://www.americanprogress.org/issues/education-k-12/reports/2018/05/09/450158/sex-education-standards-across-states/

Weaver, H., Smith, G., & Kippax, S. (2005). School‐based sex education policies and

indicators of sexual health among young people: a comparison of the Netherlands, France, Australia and the United States, Sex Education, 5(2), 171-188, DOI: 10.1080/14681810500038889

U.S. Centers for Disease Control and Prevention [CDC]. (2018). Teen Dating Violence.

Retrieved from https://www.cdc.gov/violenceprevention/intimatepartnerviolence/teen_dating_violence.html

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