Abstract
I have been interested in the topic of sexual education, also known as sex education, since high school in China. This is a very controversial topic in China and hard to promote in schools. This issue is also relevant in the U.S., North Carolina and UNC. In this paper I first discussed the history and importance of sex education. There are some unmet needs of sex education which included more information beyond physical protection and taking LGBT community into context. The technology and Internet can therefore be the future of sex education program which are presented to broad audience and presented in a more interesting way. I also investigate its role before college and at the university level. Successful education program before college will be ideal, but complement prevention efforts at college is also needed. Particularly at UNC, the SHARE program can be a helpful resource for students. A more organized and more easily accessible platform can also be implemented for students who need help regarding sexual wellness.
History of Sex Education
The history of sexuality gained momentum after the 1988 publication of John D’Emilio and Estelle Freedman’s landmark work, Intimate Matters: A History of Sexuality in America.
However, it is only in recent years that the presence of sexuality in the history of education has been emphasized, particularly in the community of primary and secondary schools, adolescents, and teachers. It has been associated with risk. The main reason is that it would assume that young people are seen as sexual beings-which goes against long-popular assumptions about young people’s sexual innocence.
One of the first work on sex education is Jeffrey Moran’s influential and groundbreaking Teaching Sex: The Shaping of Adolescence in the 20th Century. Moran’s analysis centered on the development of school-based sex education programs over the past century that were designed to change adolescent sexual behavior. (Blount 2016)
Comprehensive sex education describes a curriculum that teaches students a full range of topics including sexual consent, contraception, and sexually transmitted infections (STIs) including HIV/AIDS. In 2016, only 14.1 percent of state sex education curricula in grades 6–8 covered all Center for Disease Control (CDC)-recommended topics addressing pregnancy, HIV, and STI prevention.(Goldfarb and Lieberman 2021)
Sex education taught in the school setting, however, can be highly variable on the topics covered, the expertise of the individual providing the teaching, and state requirements.(Yoost, Ruley, and Durfee 2021)
From 2006 to 2010 and 2011 to 2013, a study showed significant declines in adolescent females’ receipt of formal instruction about birth control, saying no to sex, sexually transmitted disease. There was a significant decline in males’ receipt of instruction about birth control. Declines were concentrated among adolescents living in nonmetropolitan areas. The possible driver is the national and state educational policies emphasizing high-stakes testing in some subjects which may leave reduced time and resources for other subjects such as health education. (Lindberg, Maddow-Zimet, and Boonstra 2016)
Why Sex education
Providing sexual health knowledge to adolescents is an important means of promoting healthy sexual development and reducing possible negative consequences of sexual behaviors.
Sex education about abstinence and birth control was associated with healthier sexual behaviors and outcomes as compared with no instruction. The protective influence of sex education is not limited to if or when to have sex, but extends to issues of contraception, partner selection, and reproductive health outcomes.
National public health goals call for increasing the share of adolescents receiving formal instruction about abstinence, birth control methods, and prevention of HIV/AIDS and STIs and increasing the proportion of teens talking with their parents about these same topics. (Lindberg et al. 2016)
Comprehensive sex education was related to an increase in the likelihood of contraception at first sex compared to non-comprehensive sex education. Comprehensive sex education was also related to a lower likelihood of non-volitional first sex and higher age at first sex. (Cheedalla, Moreau, and Burke 2020)
Aside from the necessity to receive sex education, there should be raising awareness of the appropriate and best age groups at which the teenagers should receive sex education.
College sex education or before
Penetrative sexual assault includes rape and unwanted penetration due to verbal coercion. Nearly one in five women in the US report lifetime exposure to rape and about 13% of women report lifetime exposure to unwanted penetration due to verbal coercion. (Santelli et al. 2018)
Teens in Hawaii have higher than the national average rates of pregnancy and sexually transmitted infections while also having the lowest rates of condom use in the nation.(Sumida, Fontanilla, and Tschann 2018) The underlying reason might be that education was not uniformly provided across middle and high schools in Hawaii.
Sexual assault can happen to students both before and after they enter college. Multiple experiences and exposures prior to college influenced the risk of penetrative sexual assault in college. Pre-college comprehensive sexuality education, including skills-based training in refusing unwanted sex, may be an effective strategy for preventing sexual assault in college. (Santelli et al. 2018)
American universities first began to develop education programs focused on sexual assault in the 1980s but programming became much more popular on college campuses following the passage of the Crime Awareness and Campus Security Act of 1990, now known as the Clery Act (20 U.S.C.A., § 1092) and is now mandated under the Campus Sexual Violence Elimination (SaVE) Act (H.R. 2016, 112th Cong. 2013). The SaVE Act instructs colleges and universities to provide education programming for students and employees that includes primary prevention and awareness, safe and positive options for bystander intervention, risk reduction strategies, as well as ongoing prevention and awareness efforts (Thomas- Card & Eichele, 2016, as cited in Worthen and Wallace 2021).
Hundreds of campus sexual assault education programs have been developed and implemented. Studies indicate that college sexual assault education programs have significant effects on (a) reducing rape myth acceptance, the behavioral intent to rape, and the actual incidence of sexual aggression; (b) improving attitudes toward women and empathy for sexual assault survivors; (c) increasing factual knowledge about sexual assault and the willingness to report sexual assault; (d) adopting bystander intervention strategies, (e) understanding privilege; and (f) reduced associations with sexually aggressive peers (Anderson & Whiston, 2005; Barone, Wolgemuth, & Linder, 2007; Bradley, Yeater, & O’Donohue, 2009; Foubert & Newberry, 2006; Langhinrichsen- Rohling, Foubert, Brasfield, Hill, & Shelley-Tremblay, 2011, as cited in Worthen and Wallace 2021 )
A successful education program before college will be ideal, but complement prevention efforts at college would also be necessary and helpful for students.
Effort and Unmet needs
Working to Institutionalize Sex Education (WISE) Initiative is a privately funded effort to support ready public school districts to advance and sustain comprehensive sexuality programs. As a result of the WISE Initiative, more than 780 thousand unique students received new or enhanced sex education in school classrooms and about 90 school districts reached their sex education institutionalization goals. In addition to these school district successes, WISE codified the WISE Method and toolkit — a practical guide to help schools implement sex education.(Saul Butler, Sorace, and Hentz Beach 2018)
For many years, there was existing criticism on the limited focus of sex education on the treatment of the pleasure and desire aspects of sexuality. From a survey, more than two thousand adolescents from the age of 11 to 19 years were asked to formulate questions addressed to the opposite sex as part of peer-led sex education classes. Adolescents show a high degree of interest in understanding the feelings and perceptions of the opposite sex. Acquiring this knowledge could be beneficial in building emotionally and physically fulfilling relationships. To increase adolescents’ sexual and relationship competence, sexual education curricula should encompass pleasure and desire aspects of sexuality, initiating and managing relationships, societal ideals, and addressing pornography, in addition to sexual and reproductive health knowledge.(Bauer, Hämmerli, and Leeners 2020).
Sex education programs also need to be LGBTQ-inclusive. Among Millennials who were surveyed in 2015, only 12 percent said their sex education classes covered same-sex relationships. LGBTQ youth have a limited number of trusted adults they feel comfortable talking with about sexual health, so they frequently seek information online or from peers. (HRC, 2015) This suggested the potential of development of an online education program that can be more accessible for students, and help the LGBTQ community in particular.
Innovative approaches
Innovation Next, a project of Power to Decide, brings sex education into the 21st century through a unique accelerator program focused on technology-enabled ideas to prevent teen pregnancy. During spring and summer 2016, two UNC Gillings School doctoral students, Elizabeth Chen and Cristina Leos, along with a Yale colleague, Vichi Jagannathan, raised up the idea of “Real Talk,” a sex-ed app that teaches kids about sexuality through storytelling which established later in 2018. Students more eagerly shared their thoughts about everything from font size to text color to button vs. swiping preferences. (Strong 2016)
A self-study website was also successfully tested and found to be a well-accepted way to teach sex education. A study population reported an overall low-quality past experience with classroom-based sex education, and a large proportion of certain topics such as birth control methods were not taught. All 4 sessions were rated as very useful, easy to follow, and accurate, and the subjects felt the website would be acceptable for a younger high school population. (Yoost et al. 2021)
Sex education in North Carolina
According to North Carolina Youth Connected Initiative, sex education in North Carolina is called Reproductive Health and Safety Education. A bipartisan state law passed in 2009 says that all local school systems must provide medically accurate, age-appropriate sex education that includes information on abstinence, Sexually Transmitted Infection (STI) prevention, contraceptive methods, and sexual assault/abuse risk reduction in grades 7–9. The law was amended in 2013 to require more information on preterm birth, and in 2015 to add information on human trafficking. These topics that must be covered are referred to as “essential standards.”
In North Carolina, parents have the right to withdraw their child from any Reproductive Health and Safety Education lesson or all lessons. This is of the possibility to damage teens if their parents are of bias. Activities to facilitate parent-child interaction around topics covered in Reproductive Health and Safety Education would be helpful. The schools can also have activities to share the importance of sex education with parents and introduce how it works and help their children.
UNC get involved
At UNC-Chapel Hill, we have Sexual Health and Relationship Education(SHARE) program. SHARE was created to raise awareness about sexual health on the UNC-Chapel Hill’s campus, to guide students in using available health resources, and to create safe and non-judgmental spaces for students to talk about whole health behaviors and choices.
One service provided is that a student can schedule a time to speak privately with a trained sexual wellness educator about topics related to contraception, sexuality, safer sex options, family planning, and anything else related to their sexual wellness. It provided phone numbers which students can find help on the website.
There is another option of “Group Meetings”. While on the website it said “Click here to arrange safer sex and healthy relationship programs for groups, or to request our help with your sexual wellness course or event,” there is no link provided for students. The website needs to be updated in case students need the services.
In regard to the pandemic and the previous innovative practices, UNC could build a systematic online space for students to address issues regarding sexual wellness.
Works Cited
Anon. 2021. “S.H.A.R.E. | Student Wellness.” Studentwellness.unc.edu. Retrieved April 20, 2021 (https://studentwellness.unc.edu/programs/share).
Anon. 2021. “Sex Education And Schools — NC Youth Connected.” NC Youth Connected. Retrieved April 20, 2021 (http://www.ncyouthconnected.org/about-sex-education-and- schools).
Bauer, Max, Silvan Hämmerli, and Brigitte Leeners. 2020. “Unmet Needs in Sex Education — What Adolescents Aim to Understand About Sexuality of the Other Sex.” Journal of Adolescent Health 67(2):245–52. doi: 10.1016/j.jadohealth.2020.02.015.
Blount, Jackie M. 2016. “Controlling Sex: Modern Histories of Sex Education.” Reviews in American History 44(4):611–20. doi: 10.1353/rah.2016.0083.
Cheedalla, Aneesha, Caroline Moreau, and Anne E. Burke. 2020. “Sex Education and Contraceptive Use of Adolescent and Young Adult Females in the United States: An Analysis of the National Survey of Family Growth 2011–2017.” Contraception: X 2:100048. doi: 10.1016/j.conx.2020.100048.
Goldfarb, Eva S., and Lisa D. Lieberman. 2021. “Three Decades of Research: The Case for Comprehensive Sex Education.” Journal of Adolescent Health 68(1):13–27.
Human Rights Campign. 2015. “LGBTQ Youth Need Inclusive Sex Education.” HRC. Retrieved April 20, 2021 (https://www.hrc.org/resources/a-call-to-action-lgbtq-youth-need-inclusive-sex-education).
Lindberg, Laura Duberstein, Isaac Maddow-Zimet, and Heather Boonstra. 2016. “Changes in Adolescents’ Receipt of Sex Education, 2006–2013.” Journal of Adolescent Health 58(6):621–27. doi: 10.1016/j.jadohealth.2016.02.004.
Santelli, John S., Stephanie A. Grilo, Tse Hwei Choo, Gloria Diaz, Kate Walsh, Melanie Wall, Jennifer S. Hirsch, Patrick A. Wilson, Louisa Gilbert, Shamus Khan, and Claude A. Mellins. 2018. “Does Sex Education before College Protect Students from Sexual Assault in College?” PLoS ONE 13(11):1–19. doi: 10.1371/journal.pone.0205951.
Saul Butler, Rebekah, Danene Sorace, and Kathleen Hentz Beach. 2018. “Institutionalizing Sex Education in Diverse U.S. School Districts.” Journal of Adolescent Health 62(2):149–56. doi: 10.1016/j.jadohealth.2017.08.025.
Strong, Amy. 2016. “And The Winner Is… An Innovative Sex Ed App! — UNC Gillings School Of Global Public Health.” UNC Gillings School of Global Public Health. Retrieved April 20, 2021 (https://sph.unc.edu/cphm/and-the-winner-is-an-innovative-sex-ed-app/).
Sumida, Megan, Tiana M. Fontanilla, and Mary Tschann. 2018. “Perspectives of College Students About Sex Education in Middle and High School.” Journal of Pediatric and Adolescent Gynecology 31(2):179. doi: 10.1016/j.jpag.2018.02.054.
Worthen, Meredith G. F., and Samantha A. Wallace. 2021. “‘Why Should I, the One Who Was Raped, Be Forced to Take Training in What Sexual Assault Is?’ Sexual Assault Survivors’ and Those Who Know Survivors’ Responses to a Campus Sexual Assault Education Program.” Journal of Interpersonal Violence 36(5–6):NP2640–74. doi: 10.1177/0886260518768571.
Yoost, Jennie, Morgan Ruley, and Levi Durfee. 2021. “Acceptability of a Comprehensive Sex Education Self-Study Website for Teaching Reproductive Health: A Pilot Study Among College Students and Obstetrics and Gynecology Resident Physicians.” Sexual Medicine 9(1):100302. doi: 10.1016/j.esxm.2020.100302.
