Comprehensive Sexuality Education

1. Comprehensive Sexuality Education Meghan Benson, MPH, CHES Dane County Education Programs Manager September 23, 2009

2. Overview • What is sexuality? • What is comprehensive sexuality education? • What are the characteristics of comprehensive sexuality education programs? • Why are comprehensive sexuality education programs important? • Which programs work?

3. Sex vs. Sexuality • Sex – Physical acts of sexual intimacy • Sexuality – A significant aspect of a person’s life, from birth to death, consisting of many interrelated factors, including anatomy, growth and development, gender, relationships, behaviors, attitudes, values, self-esteem, sexual health, reproduction, and more

4. Sexuality Education • A lifelong process of acquiring information and forming attitudes, beliefs, and values about sexuality • Age-appropriate • Fact-based and medically accurate • Culturally competent • From many sources, including parents, family, peers, school, and community

5. Sexuality Education for Youth • Parents, guardians, and other caregivers of youth are – and should be – the primary sexuality educators for their children • However, these adults often need support and encouragement from others

6. Definition of Comprehensive Sexuality Education Programs • K-12 programs that include age-appropriate, medically-accurate information on a broad set of topics related to sexuality including human development, relationships, decision-making, abstinence, contraception, and disease prevention. - Sexuality Information and Education Council of the United States (SIECUS)

7. Comprehensive Sexuality Education Key Concept Areas • Human Development • Relationships • Personal Skills • Sexual Behavior • Sexual Health • Society and Culture

8. Age-Appropriate • Based on typical cognitive, emotional, behavioral, physical, and sexual development for a particular age group • It is important to enhance a child's growth in all developmental areas, including laying the foundations for a child's sexual growth • Adults have a responsibility to help children understand and accept their evolving sexuality

9. Examples of Age-Appropriate Sexuality Education – Ages 5-8 • Each body part has a correct name and specific function(Human Development) • There are different kinds of families(Relationships) • Children need help from adults to make some decisions(Personal Skills)

10. Examples of Age-Appropriate Sexuality Education – Ages 5-8 • Most children are curious about their bodies(Sexual Behavior) • No one should touch the private parts of a child’s body except for health reasons or to clean them(Sexual Health) • Girls and boys have many similarities and a few differences(Society and Culture)

11. Examples of Age-Appropriate Sexuality Education – Ages 9-12 • During puberty, internal and external sexual and reproductive organs mature in preparation for adulthood(Human Development) • Many skills are needed to begin, continue, and end friendships(Relationships) • To make good decisions, one must consider all of the possible consequences and choose the actions that one believes will have the best outcomes(Personal Skills)

12. Examples of Age-Appropriate Sexuality Education – Ages 9-12 • Children are not physically or emotionally ready for sexual intercourse or other sexual behaviors(Sexual Behavior) • Pregnancy can happen anytime a girl/woman has unprotected vaginal intercourse with a boy/man(Sexual Health) • People often expect girls and boys to behave stereotypically(Society and Culture)

13. Examples of Age-Appropriate Sexuality Education – Ages 12-15 • The media portrays beauty as a narrow and limited idea but beautiful people come in all shapes, sizes, colors, and abilities(Human Development) • Customs and values about dating differ among families and cultures(Relationships) • The best decision is usually one that is consistent with one’s own values and does not involve risking one’s own or others’ health and safety(Personal Skills)

14. Examples of Age-Appropriate Sexuality Education – Ages 12-15 • Sexual abstinence is the best method to prevent pregnancy & STIs(Sexual Behavior) • Young people who are considering sexual intercourse should talk to a parent or other trusted adult about their decision and about preventing pregnancy & STIs(Sexual Health) • State laws govern the age of consent for sexual behaviors(Society and Culture)

15. Examples of Age-Appropriate Sexuality Education – Ages 15-18 • Reproductive functioning is different than sexual functioning(Human Development) • Dating relationships can be enhanced by honesty and openness(Relationships) • Partners may need to assertively communicate their needs and limits(Personal Skills)

16. Examples of Age-Appropriate Sexuality Education – Ages 15-18 • Sexual intercourse is not a way to achieve adulthood(Sexual Behavior) • Individuals can help fight STIs by serving as an accurate source of information, by being a responsible role model, and by encouraging others to protect themselves(Sexual Health) • Gender role stereotypes can be harmful to both women and men(Society and Culture)

17. Resources for Age-Appropriate Sexuality Information • Guidelines for Sexuality Education K-12http://www.siecus.org/_data/global/images/guidelines.pdf • Advocates for Youthhttp://www.advocatesforyouth.org/index.php?option=com_content&task=view&id=111&Itemid=206 • There’s No Place Like Home for Sex Educationhttp://www.noplacelikehome.org/

18. Medically Accurate • Supported by the weight of research conducted in compliance with accepted scientific methods • Published in peer-reviewed journals • Recognized by leading professional organizations and agencies with relevant experience

19. Culturally Competent • Culturally competent implies having the capacity to function effectively within the context of the cultural beliefs, behaviors, and needs presented by individuals and their communities - US Department of Health and Human Services, Office of Minority Health

20. Why is comprehensive sexuality education important? • Risky sexual behavior among teens leads to negative health outcomes • Teen pregnancy rates are on the rise • 1 in 4 teens has a sexually transmitted infection • Teens experience high rates of dating violence and sexual assault • US teens’ sexual health outcomes are far worse than their peers in other countries • Significant racial and ethnic disparities in teen sexual health outcomes

21. From the CDC – July 19, 20091 • “…the sexual and reproductive health of America’s young persons remains an important public health concern: a substantial number of youth are affected, disparities exist, and earlier progress appears to be slowing and perhaps reversing. These patterns exist for a range of health outcomes (i.e., sexual risk behavior, pregnancy and births, STDs, HIV/AIDS, and sexual violence), highlighting the magnitude of the threat to young persons’ sexual and reproductive health.”

22. Does comprehensive sexuality education work2? • Comprehensive sexuality education programs have been associated with positive behavior change among youth • Postponement or delay of sexual initiation • Reduction in frequency of sexual intercourse • Reduction in the number of sexual partner/ increase in monogamy • Increase in the use of effective methods of contraception, including condoms

23. Does comprehensive sexuality education work2? • Comprehensive sexuality education programs have been associated with positive health outcomes among youth • Reduced rates of teen pregnancy • Reduced rates of STIs • Reduced rates of HIV

24. Which comprehensive sexuality education programs work2? • Advocates for Youth reviewed program evaluations demonstrating strong evidence of program effectiveness • Methods and data published in peer-reviewed journals • Experimental or quasi-experimental evaluation design with intervention and control (comparison) groups • Included at least 100 young people in each group • Continued to collect data from both groups for at least 3 months after intervention • Led to 2 positive behavior changes OR reduced rates of pregnancy, STIs or HIV in intervention youth

25. Which comprehensive sexuality education programs work2? • 26 programs strongly affected behaviors and/or sexual health outcomes among youth exposed to the program • 11 school-based • 10 community-based • 5 clinic-based • Programs were evaluated in different settings and among different populations – choose the program that works best for your group!

26. Which comprehensive sexuality education programs work2? • Choose a program based on setting • Urban (24) • Suburban (9) • Rural (6) • Choose a program based on age • Elementary school (18) • Middle school (13) • High school (20) • Young adults (9)

27. Which comprehensive sexuality education programs work2? • Choose a program based on race/ethnicity • African American (21) • Asian (9) • Latino (15) • Native American (1) • White (8) • Choose a program based on gender • Both (18) • Females only (7) • Males only (1)

28. Who supports comprehensive sexuality education3? • Parents • More than 90% of parents of adolescents • Community members • 6 in 10 voters are more likely to vote for a candidate who supports comprehensive sexuality education • Faith-based institutions • 8 religious denominations and the National Council of Churches of Christ • Professionals and professional organizations • AMA, APHA, AAP, SAM, APA, IOM • NEA, ASHA

29. QUESTIONS

30. References 1CDC. (2009). Morbidity and Mortality Weekly Report (Vol. 58, No. SS-6) – Sexual and Reproductive Health of Persons Aged 10-24 Years – United States, 2002-2007. 2Advocates for Youth. (2008). Science and Success, Second Edition: Sex Education and Other Programs that Work to Prevent Teen Pregnancy, HIV & Sexually Transmitted Infections. Accessed at http://www.advocatesforyouth.org/storage/advfy/documents/sciencesuccess.pdf on August 18, 2009. 3SIECUS. (2007). In Good Company: Who Supports Comprehensive Sexuality Education? Accessed at http://www.siecus.org/_data/global/images/In%20Good%20Company-SIECUS-%2010.07.pdf on August 18, 2009.