Formal Sex Education Research Articles

The Association Between Sex Education and Youth’s Engagement in Sexual Intercourse, Age at First Intercourse, and Birth Control Use at First Sex

Purpose Sex education is intended to provide youth with the information and skills needed to make healthy and informed decisions about sex. This study examined whether exposure to formal sex education is associated with three sexual behaviors: ever had sexual intercourse, age at first episode of sexual intercourse, and use of birth control at first intercourse. Methods Data used were from the 2002 National Survey of Family Growth, a nationally representative survey. The sample included 2019 never-married males and females aged 15–19 years. Bivariate and multivariate analyses were conducted using SUDAAN. Interactions among subgroups were also explored. Results Receiving sex education was associated with not having had sexual intercourse among males (OR = .42, 95% CI = .25–.69) and postponing sexual intercourse until age 15 among both females (OR = .41, 95% CI = .21–.77) and males (OR = .29, 95% CI = .17–.48). Males attending school who had received sex education were also more likely to use birth control the first time they had sexual intercourse (OR = 2.77, 95% CI = 1.13–6.81); however, no associations were found among females between receipt of sex education and birth control use. These patterns varied among sociodemographic subgroups. Conclusions Formal sex education may effectively reduce adolescent sexual risk behaviors when provided before sexual initiation. Sex education was found to be particularly important for subgroups that are traditionally at high risk for early initiation of sex and for contracting sexually transmitted diseases.

Lessons learnt from a secondary school Sex Education Program in Portugal

Based on a developmental framework, a study was conducted in Portugal in two groups of youth in terms of relevant aspects related to adolescent psychosexual development: one group participated in an Experimental Project of Sex Education and Health Promotion during high school, whereas the other did not receive any formal sex education in school. Within this ex‐post‐facto study, the ‘Sex Education and Psychosexual Development Questionnaire’ was administered to both groups, using the ‘mail‐type’ technique. Results reveal positive evaluations from the participants in the Sex Education Program and similarities between the groups in terms of their sexual knowledge and attitudes. However, the participants of the Sex Education Program show a multi‐oriented style of sexual information and, at a behavioural level, they refer more frequently to the use of safe methods for preventing sexually transmitted diseases. The implications of these findings for sex education in schools are discussed.

Changes in formal sex education: 1995-2002.

Although comprehensive sex education is broadly supported by health professionals, funding for abstinence-only education has increased. Using data from the 1995 National Survey of Adolescent Males, the 1995 National Survey of Family Growth (NSFG) and the 2002 NSFG, changes in male and female adolescents' reports of the sex education they have received from formal sources were examined. Life-table methods were used to measure the timing of instruction, and t tests were used for changes over time. From 1995 to 2002, reports of formal instruction about birth control methods declined among both genders (males, from 81% to 66%; females, from 87% to 70%). This, combined with increases in reports of abstinence education among males (from 74% to 83%), resulted in a lower proportion of teenagers' overall receiving formal instruction about both abstinence and birth control methods (males, 65% to 59%; females, 84% to 65%), and a higher proportion of teenagers' receiving instruction only about abstinence (males, 9% to 24%; females, 8% to 21%). Teenagers in 2002 had received abstinence education about two years earlier (median age, 11.4 for males, 11.8 for females) than they had received birth control instruction (median age, 13.5 for both males and females). Among sexually experienced adolescents, 62% of females and 54% of males had received instruction about birth control methods prior to first sex. A substantial retreat from formal instruction about birth control methods has left increasing proportions of adolescents receiving only abstinence education. Efforts are needed to expand teenagers' access to medically accurate and comprehensive reproductive health information.

Changes in Formal Sex Education: 1995–2002

Changes in Formal Sex Education: 1995–2002

Changes in Formal Sex Education: 1995?2002

Changes in Formal Sex Education: 1995?2002

Changes in formal sex education: 1995–2002

Although comprehensive sexuality education is broadly supported, prior research has suggested that abstinence-only education is becoming more common and that teaching about contraception has declined.

Perceptions of school-aged women in northeast Scotland on sex education: A focus group study

Aim To investigate the current attitudes and behaviour of young women towards formal sex education and informal sources of sexual health advice. Method Qualitative research methods were adopted in the form of focus group discussions, which included questions on sex education, sexual health campaigns and informal sources of sexual health information and advice. The group interviews were recorded. A content analysis of the transcriptions was undertaken to identify the key themes and concepts. Results Five focus groups were conducted in formal secondary-school settings and one in a community education centre. In total 31 young women aged 16–18 years participated in the study. Results showed that participants viewed the delivery of sex education as outdated and often ineffective. Teachers are not deemed to be effective providers of sex education and external healthcare facilitators are preferred. The main sources of sexual health information and advice for young women are friends, older sisters and girls' magazines, with parents and school nurses generally regarded as poor sources. Current sexual health campaigns are ineffective in targeting young people, with many unable to report any that are running at present, or the messages they try to portray. Conclusions Young women view sexual intercourse as a normal activity for adolescents to partake in. This study suggests that those working in the health and education sectors should listen to the ideas and views of young people when planning and providing sexual health education, as the current provision of sex education is perceived to be ineffective by young people in fulfilling their needs.

Sex education in Northern Ireland schools: a critical evaluation

To date there has been little research on young people and sexuality in Northern Ireland. This paper draws on the first major study in this area to analyse the delivery of formal sex education in schools. Both quantitative and qualitative methods were used to access young people's opinions about the quality of the sex education they had received at school. Overall, they reported high levels of dissatisfaction, with notable variations in relation to both gender and religious affiliation. In one sense their opinions mesh well with those of young people in other parts of these islands. At the same time the specificity of sexuality in Ireland plays a key role in producing the moral system that underlies much of formal sex education in schools. Underpinned by a particularly traditional and conservative strain of Christian morality, sex education in Northern Ireland schools is marked by conservatism and silence and by the avoidance of opportunities for informed choice in relation to sexuality on the part of young people.

Public Pedagogy: Sex Education and Mass Communication in the Mid-Twentieth Century

Questioning the relationship between medium and message has long exercised media and communications theorists, but historians have devoted comparatively little attention to the issue.1 The historiography of sexology confirms this: rather than approaching the history of sexual knowledge as the communication of expertise, historians have looked to books, manuals, films, and posters simply as sources of "evidence" of that expertise; rarely has the medium itself been the object of historical inquiry. This is curious because the first half of the twentieth century saw not only the institutionalization of sex education and the popularization of sexual expertise (notably in the marital manual) but also extraordinary developments in mass communication—in the genres of journalism and broadcasting and in the variety of media technologies available for public pedagogy. In this article we extend the historiography of sex education's usual sites of analysis by looking at two signature media of the twentieth century, the mass-circulation magazine and broadcast radio. By focusing on the medium as much as the content of the message, we can begin to connect the history of mass communication with that of sex education. In analyzing twentieth-century sex education in English-speaking cultures historians have proceeded along three broad trajectories. Those on the [End Page 71] first trajectory have studied the sexual education of children and youths newly formalized through the systematic instruction of parents as sex educators.2 Those on the second have analyzed marital manuals, which do provide a wider scope for inquiry into one print medium. Usually packaged as hardcover books and intended for adult readers' private consultation, such manuals were either purchased or studied in libraries or clinics.3 Although historians have not tended to categorize the marital manual as "sex education," readers clearly sought them for enlightenment on sexual matters.4 Those on the third trajectory have concentrated on the institutional development of formalized sex instruction in educational institutions and in the military. Generally speaking, histories of formal sex education have been based on sexological books and the instructional materials of professional sex educators. Through these media information about reproduction, contraception, venereal disease, and sexual practices ("normal" and "abnormal") was transmitted to wide audiences in libraries, the military, and (with varying degrees of government support) schools and colleges. Jeffrey Moran's Teaching Sex describes the sex-education movement in the United States during the early to mid-twentieth century as an attempt to impose controls on youth, on the newly created "adolescent," through instruction delivered within medical systems or through sex educators.5 Julian Carter has declared that starting in the 1920s "mandatory state-sponsored schooling [in the United States] . . . created the possibility for sexual pedagogy on [End Page 72] a mass level."6 But how might the historiography shift if we were to approach "education" not in its narrow institutional sense but more broadly—as advice, as instruction, as communication? Asking questions about "mass" sexual pedagogy necessarily shifts the historian's focus to mass communication, to other media for expert instruction, and to new journalistic genres of popular pedagogy, all of which functioned outside of educational, military, or religious institutions. Extending the recent historiographical move toward the epistemology of sex education—to how rather than what sex knowledge was offered and obtained7 —we suggest here that the medium as well as the content and context of the sex message calls for critical analysis. Our approach builds on work that traces important distinctions among the genres of sexual texts. Lesley Hall, for example, has examined the significance of issues like cost, binding, and foreign language quotation in medical books. These factors largely determined the reception of sex books as either learned, authoritative, and therefore respectable or popular, too easily accessible, and therefore obscene. As Hall notes, the expense and limited circulation of the earliest editions of Havelock...

A school-based randomized controlled trial of peer-led sex education in England

This article discusses the design of an ongoing cluster-randomized trial comparing two forms of school-based sex education in terms of educational process and sexual health outcomes. Twenty-nine schools in southern England have been randomized to either peer-led sex education or to continue with their traditional teacher-led sex education. The primary objective is to determine which form of sex education is more effective in promoting young people's sexual health. The trial includes an unusually detailed evaluation of the process of sex education as well as the outcomes. The sex education programs were delivered in school to pupils ages 13–14 years who are being followed until ages 19–20. Major trial outcomes are unprotected sexual intercourse and regretted intercourse by age 16 and cumulative incidence of abortion by ages 19–20. We discuss the rationale behind various aspects of the design, including ethical issues and practical challenges of conducting a randomized trial in schools, data linkage for key outcomes to reduce bias, and integrating process and outcome measures to improve the interpretation of findings.

Adolescent Ambiguities in American Pie

Popular culture is a key site in the formation of teen knowledges about sex. Yet formal sex education programs have largely ignored this arena. In this article, the author proposes the need to critically incorporate popular culture into sex education efforts to develop programs that resonate with teens' experiences and, at the same time, allow them to construct more equitable social relations. The author illustrates how this might be done through an analysis of the recent teen film American Pie. In addition, the author identifies specific implications and resources for broader theoretical efforts to reconstruct discourses of masculinity, femininity, and sexuality.

Sexuality Education and the Catholic Teenager: A Report

This article reports on findings of a study of sexuality education in a Catholic diocese. The sample included seniors enrolled in either Catholic high schools or parish religious education programs. The range of findings include data about students’ knowledge of sexuality, their understanding of Catholic Church teaching about sexuality, their attitudes and values in regard to sexuality, who and what influences their attitudes and values, their sexual behaviors, and their experience of sexuality education. Recommendations for parents and formal sexuality education programs are offered.

Issues for South Asian Indian patients surrounding sexuality, fertility, and childbirth in the US health care system.

In 1998 ethnic minorities comprised 28% of the US population, and India is the third most common country of origin for immigrants. Many recently immigrated South Asian Indian patients are seen in health care settings in the United States. To deliver health care effectively to these patients, it is helpful for physicians to understand common cultural beliefs and practices of South Asian Indian patients. Two illustrative cases are reported. One author's observations of the care of pregnant and parturient women in India and similar experiences in our own office spurred a literature search of the cultural behaviors surrounding sexuality, fertility, and childbirth. A literature search was conducted in Index Medicus, Grateful Med, and the catalogue of the University of Pennsylvania Arts and Sciences library, using the terms "Indian," "South Asian," "male and female gender roles," "gynecology in third world," "sexuality," "sexual health," "women's health," "women's health education," "obstetrical practices/India," and "female roles/India." Issues surrounding sexuality and childbirth that arise during the US physician-South Asian Indian patient encounter might not correspond to the commonly held knowledge, beliefs, and behaviors of the US health care system. Common cultural beliefs and behaviors of South Asian Indian patients around sexuality and childbirth experience include the role of the individual patient's duty to society, the patient's sense of place in society, lack of formal sexual education, prearranged marriages, importance of the birth of the first child, little premarital contraceptive education, dominance of the husband in contraceptive decisions, and predominant role of women and lack of role for men (including the husband) in the childbirth process. Lack of understanding of the Indian cultural mores surrounding sexual education, sexual behavior, and the childbirth experiences can form barriers to Indian immigrants in need of health care. These misunderstandings can also lead to patient dissatisfaction with the health provider and health system, underutilization of health services, and poorer health outcomes for Indian immigrants and their families. For this reason, it is important to teach cultural issues during undergraduate, graduate, and continuing medical education.

The History of Teaching and Talking about Sex in Schools

It has never been easy to talk about sex in schools, much less to offer any formal curriculum. That difficulty has extended to historical research on the subject as well. However, a significant body of historical work on sexuality has been published in recent decades, including John D'Emilio and Estelle Freedman's contemporary classic, Intimate Matters: A History of Sexuality in America (1988, 1997). Groundbreaking works such as this have inspired new historical scholarship on sexuality in a range of social contexts, including schools. Chief among these are two recent books on the history of sex education in United States public schools, a previously underresearched area. These two works, in turn, provide important groundwork on which a rich variety of scholarship in the history of education may yet be written. The first of these volumes, Jeffrey Moran's Teaching Sex: The Shaping ofAdolescence in the 20th Century, chronicles the development of formal sex education programs in public schools from the progressive era through the present. Moran frames these programs as means by which adults have attempted to alter the sexual behavior of adolescents. He argues that there is little evidence these programs ultimately have achieved their stated ends. Instead, sex education battles have revealed much about the values that adults have wished to impart to youth.

Adolescent pregnancy and its consequences

Objectives: This study was designed to evaluate the incidence, complications and follow-up of adolescent pregnancies.Methods: The medical records of two university departments of obstetricsand gynecology, were evaluated for the period 1985-1998.Results: From a total of 71 680 births, 5398 (7.53%) occurred in adolescent mothers, aged 14-19 years old. Among the teenage pregnancies,34% resulted in birth, 57% in abortions and 9% in miscarriage. The mean gestational age at delivery was 38 weeks and 3 days and the mean birth weight was 2880 g. The mode of delivery was normal in 84% ofcases, while 9.6% were delivered by Cesarean section and 6.4% by forceps delivery (mainly vacuum extraction). Seventy-eight per cent of cases were primagravidas. Toxemia and anemia were seen in 1.2% and0.23% of the cases, respectively. Premature separation of the placenta and placenta previa were seen in 1.08% and 1.29% of cases, respectively. Ectopic pregnancies were not seen.Conclusion:Although the teenage birth rate has decreased from 9.0% in 1985 to 5.6% in 1998, adolescent pregnancy still remains a medical and social problem. Most cases are unwanted pregnancies. The cases that havedecided to proceed with the pregnancy have presented an insignificant number of complications as assessed by adequate medical follow-up. It appears that formal sex education programs may increase knowledgeabout reproductive health and improve the use of methods to protect against pregnancy and sexually transmitted diseases.

The Hybrid Construction of Sexuality in Mexico and its Impact on Sex Education

As is now widely established, sexuality is a historically and culturally specific social construction. In Mexico, such construction has been dominated by different institutions and discourses at different times. From pre-Hispanic times to today, this article traces the ideas that main institutions, like the Catholic Church, have ingrained in Mexican sexual culture and shows how they have changed over time. At present, sexuality has become a contested arena−like never before−in which very diverse discourses contend for hegemony. Formal sex education has not been alien to this debate, in which religion, medicine, gender equity discourses and ethics seem to have a differential input in curricula and textbooks. This article discusses the expression of this tension in formal sex education in Mexico.

The Internal Triangle: Self, peers and society in boys' identity formation with implications for sexual health education

Drawing on qualitative data from a research project funded by the Economic and Social Research Council (ESRC), this article investigates boys' own construction of gender identity and the correlation between this and formal Sex and Relationships Education (SRE). It offers a simple but flexible model as a basis for understanding this correlation-or its lack-and for the construction of SRE approaches that the boys might find more relevant to their current priorities. The model takes the form of a triangle whose sides equate with the time and energy that boys are expending on the private, peer and societal aspects of their lives. The shape of the triangle alters according to shifts in this personal expenditure, forcing the individual into different areas within the triangle according to the circumstances they find themselves in at different times. The article also draws some methodological conclusions on the experience of doing qualitative research with young people in sensitive areas.

Explaining Demographic Trends in Teenage Fertility, 1980-1995

The teenage birthrate rose sharply in the late 1980s and early 1990s, and then declined in the 1990s. Attempts to explain these changes have failed to account for the changing environment in which adolescents live. Data from the 1995 cycle of the National Survey of Family Growth are used to compare the experiences of three cohorts of teenage females in the 1980s and 1990s. A life-course framework is used to examine trends in characteristics of adolescents and adolescent mothers over time, and event-history analyses are conducted to determine which characteristics are associated with the risk of a teenage birth in each cohort. A comparison of the predicted probabilities from hazard analyses shows how changes in the context of adolescence across the cohorts help explain changes in the probability of a teenage birth over time. Factors associated with the increase in the teenage birthrate in the 1980s include negative changes in family environments (such as increases in family disruption) and an increase in the proportion of teenagers having sex at an early age. Factors associated with the recent decline in the teenage birthrate include positive changes in family environments (such as improvements in maternal education), formal sex education programs and discussions with parents about sex, stabilization in the proportion of teenagers having sex at an early age and improved contraceptive use at first sex. Sexually experienced teenagers in the mid- 1990s were younger, on average, at first sex than were their counterparts in the 1980s, and thus are at an increased risk of a teenage birth. Partner factors, including nonvoluntary first sexual experiences, were not associated with the risk of a adolescent birth in any cohort. Programs to further reduce the teenage birthrate should take into account the role of family stability, parent-child communication, sex education programs and engagement in school, as well as attempt to reduce the proportion of adolescents having sex at an early age and to improve contraceptive use. The increasing risk levels among sexually experienced teenagers suggest that current programs may be reducing sexual activity among adolescents already at a low risk of a teenage birth, without addressing the needs of those at highest risk.

Sexuality and quality of life of patients with schizophrenia

Patients with schizophrenia continue to have sexual lives despite the nature of their illness. Sexuality, sexual relationships and sexual functioning are all important quality-of-life issues for these patients. Clinicians should be aware of this and not be hesitant to inquire as to the patient's experience and functioning in these areas. The importance of the patient's sexual life should be reflected in our quality of life questionnaires, and be incorporated as part of psychiatric rehabilitation programs through formal sex education. (Int J Psych Clin Pract 2000; 4:29-33)

Knowledge of and attitudes to HIV/AIDS of senior secondary school pupils and trainee teachers in Udupi District, Karnataka, India

A cross-sectional descriptive study using a questionnaire with mostly closed-ended questions was carried out on 990 pupils and 46 trainee teachers to investigate their knowledge of and attitudes to HIV/AIDS. Pupils in one school were reassessed after a health talk and distribution of a handout. Despite having had no formal sex education, most respondents were reasonably well informed about the transmission of HIV. However, there were many misconceptions about transmission and prevention and 16.9% of pupils were found to possess very little knowledge of HIV/AIDS. Mass media, teachers and health workers were quoted as the main sources of knowledge. It was found that 24.3% pupils and 6.3% of trainee teachers thought there was a cure, and 27.4% of pupils and 14% of trainee teachers thought there was a vaccine to prevent HIV infection. Schools that were rural, private and English-speaking scored better, as did male students and schools teaching science. The necessity of formal sex education was expressed by 98.5% of pupils and all the trainee teachers. The pupils who were reassessed after receiving a talk and handout showed significant improvement in their knowledge and a change in attitude (p < 0.01). The mass media are important in disseminating knowledge on HIV/AIDS in India but due to the lack of inter-personal approaches to the education system, knowledge is inadequate and misconceptions exist.