P-493 Sex and fertility education in the UK: an analysis of biology curricula and students’ experiences

Abstract

Study questionWhat is currently being taught in United Kingdom (UK) secondary schools relating to sex and fertility and what are students’ experiences of this education?Summary answerThere are large gaps in the UK’s biology curriculum relating to sex and fertility education with important topics being neglected.What is known alreadySex and fertility education is essential to enable people to make informed choices about family building. This is especially important as maternal and paternal age is increasing globally. School is an important source of this education but sex and fertility education is often minimal. In order to optimise people’s contraceptive behaviour and fertility planning, an understanding of the reproductive cycle, basic physiology of fertility and preconception health is required. Fertility education interventions have been shown to improve fertility knowledge and decrease planned ages of childbearing among young adults but only if repeated.Study design, size, durationThis study aimed to evaluate the current biology curricula relating to sex and fertility education at GCSE (General Certificate of Secondary Education) and A level (Advanced Level) in the UK and to determine 16-17-year-old students’ experiences of their sex and fertility education. This year group was chosen as we are interested in what students have learnt by the end of their mandatory education (years 1 to 11), and their experiences of this education.Participants/materials, setting, methodsThe analysis of the curricula was conducted using the most recently published specifications for science and biology at GCSE and biology at A level for the Awarding Bodies that dominate the GCSE and A-level market in the UK. The school survey included a 47-item online survey distributed to year 12 students in four secondary schools across England. In total, 244 students participated in the survey.Main results and the role of chanceThere are six Awarding Bodies in the UK that set the examinations for GCSE and A-level students. At GCSE level, the hormonal control of the menstrual cycle, contraception and ART are taught within the human reproduction section of the biology curriculum. STIs are used as examples of communicable diseases, but pregnancy does not feature other than as a consequence of contraceptive failure. At A level, there is generally less teaching of relationships, sexuality and fertility-related topics than at GCSE. The results of the school survey showed that some topics, notably puberty, the menstrual cycle, contraception and STIs, were more likely to be learnt in school. However, topics such as endometriosis, menopause, miscarriage and polycystic ovarian syndrome were more likely to be learnt outside school. Abortion was the most common topic learnt outside school, followed by puberty. The most popular sources of sex education outside school were the internet and social media. In the students’ responses to how they think sex and fertility education can be improved, six themes became apparent: LGBTQ + (lesbian, gay, bisexual, transgender, queer and others) inclusivity; topic variety; logistical improvements; attitudes towards sex; gender equality; and applicability to real life.Limitations, reasons for cautionThe COVID-19 pandemic significantly disrupted schools during the 2020/2021 academic year. Consequently, we were unable to distribute the survey to as many schools as planned. We hope to continue this study in the 2021/2022 academic year to allow further comparison between the experiences of different groups of students.Wider implications of the findingsIdeally, school sex and fertility education would involve a comprehensive and holistic programme and would provide young people with full, accurate information to prepare them for later life. We hope that the results of our study can be used to improve sex and fertility education for young people.Trial registration numberNA