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Sex Education In Public Schools: How Can We Be More Effective?

Every year, 9 million fifteen to twenty-four year olds are diagnosed with a sexually transmitted infection (Armbruster, Brown, Kovar, Sodovsky, 2006) and 900, 000 teenage girls become pregnant (Tanne, 2005). Individually, or the combination of these events can have detrimental effects on the health of a young woman. Although these numbers have been declining in recent years, it seems there is still more that can be done to further reduce this trend. If more comprehensive Sex education was offered in the public school setting as a requirement, the rate of pregnancies and sexually transmitted infections among young women in the United States would decrease.

Sexually transmitted infections (STIs) may lead to several medical complications such as pelvic inflammatory disease, coronary artery disease, cancers of the genitalia, dementia, and death in some cases. As a result of pelvic inflammatory disease, infertility, tubo-ovarian abscess, ectopic pregnancy, chronic pelvic pain, dyspareunia, tubal scarring, and extrapelvic infection can develop. Along with the physical effects, women must also deal with the psychological effects of contracting an STI. Victims report negative emotions such as anger or depression, sometimes lasting more than a year. Some women are reluctant to seek treatment out of fear that their partner or family members will no longer accept her if they were to find out. It is estimated that 6.5 billion dollars are spent on STI treatments for fifteen to twenty-four year-olds per year (Armbruster et al., 2006). The number of adolescents who use barrier contraceptives has increased due to HIV and STI education, but only sixty-three percent of adolescents report using a condom the last time they had intercourse (Tanne, 2005).

Teen pregnancy has declined by twenty-five percent since 1991(As-Sanie, Gantt, & Rosenthal, 2004). However, the United States continues to have the highest number of births to teenage mothers of the industrialized countries (Tanne, 2005). Teenage mothers have more than a seventy-five percent chance of needing public assistance within five years of giving birth, and they are less likely to finish high school (As-Sanie et al., 2004).

According to a study published in 2006, most American women's primary source of Sex education is their friends, and a large number used the internet as a source of information. The study concluded that adolescents preferred the information they "sought out" rather than the information that had been formally provided through schools, parents, doctors, or clinics (Williams & Bonner, 2006). These findings are reason for concern, as they may provide a significant amount of false information. Even though there are online sources that are reliable, there is no way to ensure that these are the websites that adolescents are visiting. In order to improve this situation, it would be beneficial to both female and male adolescents if accurate and thorough information were provided in the school setting by instructors who are comfortable with the topic at hand, starting at the middle school age level. This way, it can be guaranteed that the information students receive will be correct and useful.

Abstinence-Only-Until-Marriage Sex Education Programs

Abstinence-only programs devote forty percent or more of their content to abstinence education. These programs are the only sex education programs that can receive federal funding due to the conservative view points of the current administration. In a review of twenty-one programs used in schools, on average, forty-eight percent of the program focused on abstinence, twenty percent to character education or youth development themes, thirteen percent to healthy sexuality, ten percent to STI prevention, and four percent to pregnancy prevention. Most of these programs failed to mention more controversial, but important aspects of sexuality. Seventy-one percent did not mention masturbation, sixty-seven percent did not address "diversity of sexual values and behaviors in American society, " sixty-two percent failed to mention "human development through the life span, sexual identity and orientation, and the common occurrence of sexual fantasies." The average rating for the accuracy of the anatomy and physiology portions of these programs was "inadequate." The authors of the review provided this false quote from one of the reviewed programs:

"...the outward direction of sperm cells is supported by emphasis on an out ward direction in the male's personality... The ovum, by contrast, is receptive and more inward-directed... the female personality is generally more receptive and inward than the male's."

The creators of these programs tend to focus more on "nonsexual antecedents of sexual behavior such as skills, ideals, and psychological factors such as self-esteem" rather than healthy sexuality, STI prevention, and pregnancy prevention. Many "systematically omit" controversial subjects that should be recognized (Buhi, Davis-Gunnels, Goodson, Pruitt, & Wilson, 2005). Follow up studies of the Postponing Sexual Involvement program, which was presented in thirty-one counties in California, found "no significant difference in pre- and post-intervention self-reported scores on the initiation of Sex, frequency of Sex, number of sex partners, use of condoms and other birth control methods, or reported pregnancy rates.(As-Sanie et al., 2004)." While these programs succeed in communicating the importance and awareness of abstinence, they have not decreased sexual activity, pregnancy, or the rate STIs among adolescents (Tanne, 2005).

Comprehensive Sex Education Programs

Comprehensive sex education programs provide abstinence information as well as STI prevention, contraception, and anatomy and physiology. These programs are not encouraging sexual activity; they are providing more practical information. Most young women who come in contact with sex education programs, whether it be an abstinence only or comprehensive program, are still going to have sex and they need to be prepared with the right information before they do so. More than forty-five percent of high school aged girls are sexually active, with seventeen being the average age of first intercourse (Tanne, 2005). Begining sex education at the junior high/middle school level would ensure that a majority of adolescents would have prior knowledge of sexual health at the age of first intercourse. Not only would it be more practical to include this information in sex education programs, it is what the students themselves want.

In a survey given to young Adults ranging from eighteen to twenty-eight years old, participants were questioned on the quality of sex education they had received and what they thought could be done to improve it. Ninety-one percent wanted to know more about STIs with an emphasis on incidence, effects, and consequences on the body. Sixty-one percent wanted to know more about STI prevention, and forty-seven percent wanted more instruction on contraception (specifically how to use it, and where to obtain it) and pregnancy. The instructor giving the course was also a concern of the students. Students expressed some interest in having a presenter with personal experience with STIs (thirty-eight percent), and students from multiple studies wanted a caring, nonjudgmental instructor who is comfortable and confident in teaching this material (Armbruster et al., 2006; Byers, Cohen, Sears, Thurlow, Voyer, & Weaver, 2003; Wight & Buston, 2003). It was also suggested that instructors use fiction from media, such as books or television shows, as teaching aids (Armbruster et al., 2006). While the focus of this topic is the United States, findings of a similar survey given in Canada mirrored the results of the United States survey.

With this knowledge women can be more in control of what happens to their bodies because they will be more confident when it comes to making decisions, thereby, increasing their sexual assertiveness. Sexual assertiveness is defined as the ability to effectively communicate sexual beliefs and desires. Not being able to be sexually assertive can make a woman vulnerable to unplanned pregnancy, STIs, sexual coercion, violence and other negative sexual experiences. A study of 904 women published in 2002 yielded these alarming results:

...8-9% believed that they never have the right to make their own decisions about sexual activity, regardless of their partners' wishes, or to tell their partners when they are or are not interested in Sex... Larger proportions (15-19%) believed that they never have the right to make decisions about contraception regardless of their partners' wishes; to tell their partner that they do not want to have intercourse without birth control, that they want to make love differently or that he is being too rough; to ask their partner if he has been examined for STDs; to stop foreplay at anytime, including at the point of intercourse; and to refuse to have intercourse, even though they may have had sex with that partner before and enjoyed it...49% reported that they never have the right to masturbate to orgasm (Rickert, Sanghvi, & Wiemann, 2002).

Not only do these women feel they do not have the right to protect themselves, they a feel they do not have the right to fully enjoy themselves during Sex. Building sexual assertiveness includes "building proficiency in risk-reduction skills" (Rickert et al., 2002). Building proficiency should entail acquiring the correct knowledge of where to find and how to use different methods of protection and contraception. While there are some women who are not fortunate enough to attend middle school and high school, most of them are. The school setting provides a common place for most adolescents to learn. It is necessary for the health and well-being of all American women that this information be given to them in school as a part of their required education.

References

Armbruster, M., Brown, C., Kovar, C. K., Sadovsky, V.C. (2006). The need for sexual health information: perceptions and desires of young Adults. The American Journal of Maternal Child Nursing, 31(6): 373-379.

As-Sanie, S., Gantt, A., & Rosenthal, M. (2004). Pregnancy prevention in Adolescents [Electronic version]. American Family Physician, 70(8): 1517-1524.

Bonner, L. & Williams, M.T. (2006). Sex education attitudes and outcomes among North American women [Electronic version]. Adolescence, 41(161): 1-14.

Buhi, E., Davis-Gunnels, E., Goodson, P., Pruitt, B. E., & Wilson, K. L. (2005). A review of 21 curricula for abstinence-only-until-marriage programs [Electronic version]. Journal of School Health, 75(3): 90-98.

Buston, K., & Wight, D. (2003). Meeting needs but not changing goals: evaluation of in-service teacher training for sex education [Electronic version]. Oxford Review of Education 29(4): 521-543.

Byers, E. S., Cohen, J. N., Sears, H. A., Thurlow, J. L., Voyer, S. D., & Weaver, A. D. (2003). An adolescent perspective on sexual health education at school and at home: I. high school students. The Canadian Journal of Human Sexuality, 12(1): 1-17.

Rickert, V. I., Sangvi, R., & Wiemann, C. M. (2002). Is lack of sexual assertiveness among adolescent and young women a cause for concern? [Electronic version]. Perspectives on Sexual and Reproductive Health, 34(4): 178-183.

Tanne, J. H. (2005). Teenagers need sex education, not just abstinence advice. BMJ, 331: 129.

By hdhugelman - I'm a recent graduate from Truman State University with a B.S. in Psychology. I am currently figuring out what to do with my life.  

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