Article summary with Comprehensive Sexuality Education by Vanwesenbeeck - 2020

Why is sexuality education important for young people?

Sexuality is a central aspect of being human. It encompasses sexual behaviors, sexual orientations, eroticism, gender identities and reproduction. Adolescents want to learn about sex and have a right to accurate information. It is crucial to their development of identity, morality and the capacity of intimacy. Parents and peers play a socializing role, but they are not always the best at meeting the needs of the young people when it comes to sexuality education. That is why states and schools need to take this responsibility.

What is comprehensive sexuality education?

UNESCO defines comprehensive sexuality education (CSE) as a curriculum-based process of teaching and learning about the cognitive, emotional, physical and social aspects of sexuality. Its goals are to provide young people with knowledge, skills, attitudes and values that empower them to realize their health, well-being and dignity, develop respectful social and sexual relationships, and ensure the protection of their rights. A distinction can be made between conventional health-based CSE and rights-based empowerment CSE.

What is conventional health-based CSE?

Conventional health-based CSE provides curriculum-based, scientifically appropriate information on reproductive and sexual physiology and contraceptive and protective methods. Its main goal is to prevent sexual risks and other negative outcomes, such as sexually transmitted infections, HIV infections, and unplanned pregnancies. It promotes all available strategies to sexual prevention, including abstinence, safe sexual practices and the use of condoms.

What theory underpins conventional CSE?

Conventional CSE is theoretically driven by behavior change theory. It emphasizes social norms and values, attitudes, relationships and social skills as determinants of sexual health behavior.

What is rights-based empowerment CSE?

Empowerment CSE is about advancing young people´s knowledge, attitudes, and skills supportive of making informed sexual choices and of building safe and respectful relationships. It includes awareness of cultural, ideological, political and religious contexts and of the ways these contexts affect people´s sexual choices, behaviors, and relationships. It promotes sex positive values, such as mutual respect, human sexual rights, and gender equality.

What are the goals of empowerment CSE?

Empowerment CSE aims to contribute to societal transformation and to strengthen young peoples´ roles in these processes. One of its main learning objectives is to give young people the capacity of critical reflection and successful navigation of normative contexts. It tries to teach sex cultural intelligence, media-literacy and help-seeking skills. It encourages non-sexist attitudes and behaviors and empowers young people to achieve safe, consensual, egalitarian relationships and gender equality.

What are the eight concepts that are key to empowerment CSE?

Eight concepts are important to CSE curricula: 1) relationships, 2) values, rights, culture and sexuality, 3) violence and staying safe, 4) understanding gender, 5) the human body and development, 6) skills for health and well-being, 7) sexual and reproductive health, and 8) sexuality and sexual behavior.

What factors are important for successful delivery of empowerment CSE?

• It needs to be age and developmentally appropriate. It needs to be responsive to the changing needs and capabilities of young people and address developmentally relevant topics in a timely, diversity accommodating fashion.
• It needs to engage learning in a continuing educational process that starts at an early age and builds new information upon previous learning.
• It needs to be learned-centered and adjusted to the concerns, realities, interests, suggestions and resistance of young people.
• It needs to involve active participation of students so they become capable of making their own decisions.
• Teachers need to facilitate empowerment and not just teach content, regulate behavior or improve knowledge.

According to scientific results, what are the positive consequences of good quality CSE?

Good quality CSE has many positive results:

• Young people develop accurate and age-appropriate sexual knowledge, attitudes, skills, intentions and behaviors that contribute to safe, healthy and positive relationships.
• It provides young people with information about their bodies and sexuality.
• It reduces misinformation, shame and anxiety.
• It clarifies and solidifies positive attitudes and perceptions.
• It increased communication.
• It improves young people's overall sexual agency and abilities to make safe and informed choices about their sexual and reproductive health.
• It delays young people´s debut of sexual intercourse.
• It reduces the frequency of unprotected sex.
• It increases the utilization of sexual and reproductive health services and contraceptives.

Which factors are important for successful empowerment CSE?

Four factors can be identified:

• A comprehensive program content.
• An adequate delivery and implementation of the CSE.
• An enabling environment.
• The use of multicomponent approaches.

How can a good comprehensive program content be created?

With regards to program content, it is important that recommended procedures are followed. This includes using a logic model, involving young people, assessing local needs and testing the program. Other aspects that are important are giving clear messages and focusing on risks that can be changed and situations that may lead to unsafe sex. Meanwhile, personal values, norms and perceptions need to be addressed and self-efficacy needs to be enhanced. Finally, gender and power should be explicitly addressed by fostering personal reflection and critical thinking.

What can cause a well developed CSE program not to be implemented or delivered well?

Several factors can be identified that may stand in the way of a good implementation of a CSE program. They can be divided into three categories, namely factors related to students, teachers and school contexts. For example, students may not be able to attend lessons, teachers may skip too controversial messages and schools may be unable to provide materials or effective lesson plans.

What role do teachers´ skills and norms play with regards to adequate delivery of CSE?

Positive effects of CSE are largely due to the motivation, attitudes and skills of teachers and their ability to employ participatory teaching techniques. Many teachers struggle to come to terms with teaching CSE and their dominant socio-cultural and religious norms. The CSE program may be conflicting with the teachers´ norms and identity. Teachers may inadvertently strengthen traditional gender norms rather than transform them. Finally, pupils and teachers may feel embarrassed and uncomfortable discussing sexuality.

How can the (school) environment enable a good implementation of a CSE program?

Sexuality education should be structurally embedded in the official curriculum and not be provided in after-school hours with little organizational support. There should be positive messages and no gender and status power differences between teachers and learners and risks of harassment, exploitation and violence against and among students should be minimized.

What are multicomponent approaches?

Multicomponent approaches bring actions together to improve individual empowerment, strengthen the health system and create a more supportive environment for good CSE. They are more sustainable than single-component interventions, because they also cause change in social and cultural factors. One example is an ecological framework than enables the environment at different levels:

• The individual level (e.g. by empowering girls and creating safe spaces).
• The relationship level (e.g. by building parental support and peer support networks).
• The community level (e.g. by transforming gender and social norms).
• The societal level (e.g. by promoting laws and policies that protect and promote human rights).

What are aspects with regards to successful CSE programs that need attention?

CSE requires constant innovation and needs to be continuously adapted to new insights, societal development and shifting conditions. It is always a work in progress, but two areas are identified that need extra attention:

• The transformative goals of CSE may be unsettling to some and they consider them threatening to gender norms, family values and the status quo. Particularly sexual rights and same-sex sexual relationships remain extremely controversial. This causes opposition to CSE to remain very strong in many countries.
• Difficulties with international cooperation. Certain factors make international cooperation very difficult, including colonial histories, positions in the global economy and the nature of economic funding. Countries tend to impose their values on other countries which often leads to frustration and resistance to a rights-based CSE approach.