How should mandatory sex education be taught?BMJ 2017; 357 doi: https://doi.org/10.1136/bmj.j1768 (Published 11 April 2017) Cite this as: BMJ 2017;357:j1768
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I was delighted to hear about the government’s new plans to make sex and relationship education (SRE) compulsory in schools (1). Having left school not long ago, it was of uniform opinion amongst students that there was not enough provision of the subject. Even when we had the occasional lesson it was far from useful. Reading this article’s suggestions on how SRE should be implemented has made me reflect on what I believe could be improved from my own experiences.
I spent 2 weeks this year studying sexual health as part of my medical school curriculum, and was quite surprised at my own ignorance. I had never realised to what extent sexually transmitted illnesses (STIs) were prevalent, even though there were numerous people my own age coming into the walk-in sexual health clinics with histories of chlamydial and gonorrhoeal infections. In hindsight, this was not abnormal; a comprehensive survey of the U.K. found that almost one in twenty women aged 18-19 and one in thirty men aged 20-24 have chlamydia (2). Reflecting on my own sexual education at school, although we were taught how to use condoms, this was always with the focus of not getting pregnant as opposed to not contracting STIs. Obviously, this may not be the case in every school, but perhaps it would be good if there were a larger focus on the incidence and symptoms of STIs, to increase awareness of the importance of using protection. This is especially important as approximately 30% of those surveyed aged 16-24 claimed they had sex before the age of 16 (2), so school will be their only source of information at that age.
I really liked the idea the article put forward of employing a specific SRE teacher who delivers this information. I remember being taught about relationships by a teacher at school, as me and my colleagues squealed with embarrassment. This was subsequent to having an I.T. lesson in the same room with her just previously. It felt extremely uncomfortable and although she had good intentions, it was never going to be effective enough to help guide our decisions. In addition, as the article highlighted and as was found in this survey, there have been new developments in sexual behaviour. The average number of partners females have in a lifetime has more than doubled, and the number of females are having same-sex experiences quadrupled between 1990 and 2010 (2). It is difficult for school teachers to keep updated with these changes and know how to teach such sensitive issues.
The article also proposed another model, whereby external sexual health professionals collaborate with teachers to deliver SRE. I have had first hand experience of this model, as I took part in a volunteering scheme run by my university called Sexpression (3). Sexpression is a network of student-led projects based in over 25 universities which sends volunteers into schools to provide SRE. This worked really well because we were not dissimilar in age to the secondary school students we were teaching, and I certainly observed them learn a lot in the sessions we delivered. However I could not help but notice that the students kept peering behind at their teacher, feeling too embarrassed to answer or ask questions. Having said that, I wonder if that was because it was their teacher or whether this was because it was a girl’s school and the teacher in question was male. Perhaps this is another consideration: would it be best to separate girls and boys and have them be taught by a teacher of the same gender to reduce embarrassment? More research into this would be useful to ensure the best possible provision of SRE.
I have barely touched on the content that encompasses sexual and relationship education, yet it is clear that the sensitive nature of the topics means that it is difficult finding the optimal way to deliver the information. As sexual health services are currently experiencing cuts in their funding (4), it is more important than ever to empower young individuals with the information they need to make sensible choices. I look forward to seeing how the government plans to do this.
1. Pound P. How should mandatory sex education be taught?. BMJ. 2017;:j1768.
2. Mercer CH, Tanton C, Prah P, et al. Changes in sexual attitudes and lifestyles in Britain through the life course and over time: findings from the National Surveys of Sexual Attitudes and Lifestyles (Natsal). Lancet 2013;357:1781-94.
3. Home [Internet]. Sexpression:UK. 2017 [cited 13 April 2017]. Available from: http://sexpression.org.uk
4. Iacobucci G, Torjesen, I. Cuts to sexual health services are putting patients at risk, says King’s Fund. BMJ. 2017;:j1328.
Competing interests: No competing interests