Wake Up and Smell the Condoms: An Analysis of Sex Education Programs in the United States, the Netherlands, Sweden, Australia, France, and Germany

While each state should be free to establish a program that most meets the needs of its population, there should be some principles common to all programs. First, the programs should provide comprehensive information about sexuality, relationships, sexual identities and diversity, setting boundaries and respecting the boundaries of others, developing effective communication skills, preventing STDs, successfully using contraception. Sex should be regarded in a positive way; programs should not induce fear or deny the pleasurable aspects of sex. Sexual development should be viewed as a normal part of growing up, and sex within relationships should be presented as an ideal, without condoning other sexual relationships. Students should be encouraged to explore their own sexuality through masturbation before engaging in sex with a partner.

For sex education programs to be effective they must do more than just provide information. Effective sex education programs must influence psychological processes of decision-making and pursuing goals. These programs should be informed by cognitive theories that have been used successfully to address other health behaviors, like drug abuse prevention programs (Schaalma et al., 2004) . Sex education programs need to provide students with decision-making, communication and negotiation skills and an ability to resist social pressure (Schaalma et al., 2004).

One of the most effective means of teaching these concepts is through social rehearsal or role playing activities. These activities provide students with skills to deal with many situations and are especially useful to students who don’t yet have actual experience with these situations (Schaalma et al., 2004). Because sexuality is a sensitive topic for many students, a safe classroom atmosphere must be maintained. Students must comfortable participating in activities and asking questions in order to truly benefit from sex education courses. A safe atmosphere can be established by setting confidentiality rules and engaging the class in “feelings-and-values” exercises before introducing the sex education topics. “Feelings-and-values” exercises encourage students to discuss feelings of embarrassment and what they mean, as well as set limits about what information is appropriate to disclose in a classroom (Schaalma et al., 2004).

Media literacy, defined as the ability to access, analyze, evaluate, and communicate messages in a wide variety of forms (Pendleton, Austin, Cohen, Chen, & Fitzgerald, 2008), should be an important component of sexuality education in the United States, where adolescents report that they view television as an important source of information on birth control, contraception, how to talk to a boyfriend or girlfriend about sexual issues, and norms for sexual behavior (Eye, Kunkel, Bialy, & Finery, 2007).

Media literacy has proven to be an effective component of sex education in the past and research has shown that individuals who understand media production recognize that messages in the media are carefully constructed and are better able to identify motives, purposes, and points in the media they are exposed to (Pendleton et al., 2008). Images of sexuality dominate media in the United States and students need to be equipped with skills to analyze and deconstruct the messages they receive.

The United States should also initiate social health programs that support the values being taught in sex education and allow teens access to sexual health services. A national health insurance program should be developed to cover every citizen under age eighteen. This insurance program should fund all reproductive health services. Condoms should be cheap and easily accessible; putting vending machines in school restrooms and other public restrooms would be a good way to spare teens any embarrassment about buying them at a pharmacy. Sexual health clinics should be established in locations that are easily accessible to youth and be open during after-school hours and on weekends.

These clinics should follow the same guidelines as those in the Netherlands: accept teen sexuality and sexual behavior, guarantee anonymity, waive Pap smear and pelvic exams for initial contraceptives, provide nonjudgmental service, and require minimal paperwork and no parental consent (Lottes, 2002). Abortion should be free and legal and minors should not be required to have parental consent. I do support requiring pre- and post-procedure counseling to women of any age who seek abortions, but this counseling should be supportive and nonjudgmental. Finally, national mass media campaigns should encourage safe sex and responsible decision making and make youth aware of the resources available to them in their community.

In summary, the United States has failed its youth and put their health at great risk by denying them adequate sex education and sexual health services. The Netherlands, Sweden, Australia, France and Germany all show better results on measure of teenage sexual health than the United States. While these countries each have unique sex education programs, they all provide comprehensive information about sexuality, STDs, and contraception, and represent sexuality as a normal and positive part of human development. Teen sexuality is normalized in these countries and youth are encouraged to set their own boundaries, respect others, and make informed, responsible choices.

In addition to their sex education programs, all of these countries have social programs in place to provide youth with sexual health services and contraception. The United States needs desperately to abandon the abstinence-only approach to sex education and develop comprehensive sex education programs and should look to these countries for inspiration. Social programs providing sexual health services to teens similar to the ones in each of these countries should be developed to supplement the new sex education programs.

Of course, there are obstacles to achieving these goals. Sex education is a largely moral issue in the United States and many religious groups fight adamantly against anything but abstinence-only programs. Many adults have misconceptions about comprehensive sex education, believing it will cause youth to become sexually promiscuous, which has been proven untrue (Labauve & Mabray, 2002). The foreign countries presented in this paper have much more open, matter-of-fact attitudes about sexuality, as opposed to the puritanical views prevalent in the US. The US will need to adopt a fact and research based approach to human sexuality before any of the programs I suggest can be initiated at a national level.

Discouragingly, even if the US adopts a comprehensive sex education curriculum and funds sexual health services for youth, the entire problem will not be solved. Other major causes of poor sexual health in the US are the high poverty rates and uneven distribution of wealth (Lottes, 2002). As long as high numbers of American youth are living in poverty, US teen sexual health will continue to rate worse than that of other industrialized countries. Addressing these issues is extremely complicated and a topic that must be saved for another paper.

While the US situation appears grim right now, there is hope. The recent election demonstrated a shift to the left in US politics. Hopefully the new administration will abandon unsuccessful abstinence-only policies in favor of research-based comprehensive sex education programs. Citizens should encourage national and local governments to fund sexual health services for youth and push for a national health insurance system that covers all citizens. When these goals are accomplished, we should begin to see a much more sexually responsible youth.

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References

Australian Research Centre in Sex, Health and Society. (1999). Talking sexual health: National framework for education about STIs, HIV/AIDS and blood-borne viruses in secondary schools.

Berne, L., & Huberman, B. (1999). European approaches to adolescent sexual behavior and responsibility. Washington, D.C.: Advocates for Youth.

Darroch, J., Singh, S., & Frost, J. (2001). Differences in teenage pregnancy rates among five developed countries: The role of sexual activity and contraceptive use. Family Planning Perspectives, 33(6), 281-250.

Eyal, K., Kunkel, D., Biely, E. N., & Finnerty, K. L. (2007). Sexual socialization messages on television programs most popular among teens. Journal of Broadcasting & Electronic Media, 51(2), 316-336.

Ferguson, R. M., 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.

Labauve, B. J., & Mabray, D. (2002). A multidimensional approach to sexual education. Sex Education, 2(1), 31.

Lottes, L. L. (2002). Sexual health policies in other industrialized countries: Are there lessons for the united states? Journal of Sex Research, 39(1), 79-83.

McConaghy, M. J. (1979). Sex-role contravention and sex education directed toward young children in sweden. Journal of Marriage & Family, 41(4), 893.

Peppard, J. (2008). Culture wars in south australia: The sex education debates. Australian Journal of Social Issues, 43(3), 499-516.

Pinkleton, B. E., Austin, E. W., Cohen, M., Chen, Y., & Fitzgerald, E. (2008). Effects of a peer-led media literacy curriculum on adolescents' knowledge and attitudes toward sexual behavior and media portrayals of sex. Health Communication, 23(5), 462-472.

Schaalma, H. P., Abraham, C., Gillmore, M. R., & Kok, G. (2004). Sex education as health promotion: What does it take? Archives of Sexual Behavior, 33(3), 259-269.

Singh, S., & Darroch, J. E. (1999). Adolescent pregnancy and childbearing: Levels and trends in developed countries. Family Planning Perspectives, 32(1)

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.

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Endnotes

1.) Data for US teen births differs from previously mentioned data because it is taken from a different study. The previous study did not include Australia.