I recently attended the National Congress of Sexual Education and Sexology sponsored by the Mexican Federation of Sexual Education and Sexology (FEMESS) in Oaxtepec, Mexico.
I talked about the barriers, necessities, and opportunities that are confronting sexuality education now and in the future. I called for a strategic plan for the next generation of sexuality education programs.
Education is the basic tool by which we can confront the sexual health problems we face around the world. We see the HIV pandemic stabilizing overall but growing rapidly among disadvantages groups. Sexual violence is still at unacceptable levels. Gender equity remains ideal rather than a reality. Individuals and couples are struggling to find sexual satisfaction and pleasure. We have a syndemic - a constellation of epidemics that feed one another. We are going to need a systematic approach to promote sexual health to address the syndemic. This is not just a sexual health problem but a public health problem. Sexual health is essential to overall health and human development.
There are enormous barriers to overcome. We need to face some fundamental facts.
● There is the ubiquitous taboo of talking about sex in our cultures and this is not going to go away.
● Parents, by the nature of parent-child dynamics, are never going to be the most effective sexuality educators.
● We can not seem to get over the notion that to talk about sex with children means that they are more likely to engage in sexual activity (and irresponsibly).
● Sexual education is a threat to the social order which preserves patriarchy and heteronormativity.
● Science-based sexual education is a threat to certain religious views and beliefs.
● The belief that the state should not interfere in something so private as one's sexuality
● Sexual education by professionals in structured environments is the only way to deal with these barriers.
Despite the barriers, we have tremendous opportunities to overcome them. The United Nations has declared 8 human development goals for 2015. Embedded in these goals are a few of them that specifically address sexual and reproductive health. However, in all of these 8 goals, promotion of sexual health is obviously a means of addressing them. (See the World Association for Sexual Health's (WAS) Declaration and Technical Document - Sexual Health for the Millennium). The fundamental premise of this declaration is that it is essential to promote sexual health to enhance overall human development. Sexual health is on par with the necessity to promote physical and mental health. The three are like a three-legged stool and without one - the chair will fall.
The fourth point of the WAS Declaration specifically addresses the importance of providing universal access to comprehensive sexuality education. To achieve sexual health, all individuals, including youth, must have access to comprehensive sexuality education and sexual health information and services throughout the life cycle. This has been recognized more and more in health promotion strategies as illustrated by the Inter Ministerial Declaration of Health and Education Ministers of Latin America and the Caribbean and the Maputo Plan of Action that was endorsed by the Ministers of Health from 48 African countries and their governments. So there is openness and opportunity to build upon when public policy officials are recognizing the importance of sexual health education as a general public health policy.
Sexual health has been legitimized in public health policy and science will be needed to guide it. It is a unique opportunity in history that we must seize.
In order to overcome these barriers and seize these opportunities, we have the following necessary actions.
● Provide mandatory comprehensive sexuality education - that is rights-based, gender sensitive, and culturally appropriate - as an essential component of school curricula at all levels and provide the necessary resources.
● Work with community organizations to reach young people who are not in school or other high-risk populations with comprehensive sexuality education.
● Issue guidelines to ensure that sexuality education programs and services are grounded in the principle of fully informed, autonomous decision-making.
● Ensure that sexuality education programs are evidence-based and include the characteristics that have been shown to contribute to effectiveness. This should be done in a way that allows for creativity and community specific needs in the development and evaluation of innovative programs.
● Promote further research in human sexuality education designed to promote sexual health and responsible sexual behavior.
We only have a few years to show that comprehensive sexuality education can work before the tides can turn and we return to abstinence-only approaches.
We must create a better climate for discussion of sexuality.
We need to ensure access to information and access about sexuality.
We need a society where every child (no matter what their sexual or gender identity) can get basic sexuality information.
We need to ensure that every health care provider is trained to address sexuality as part of their practices.
And that is the only way that we will achieve sexual health and foster human development.
African Union Commission. (2006). Plan of Action on Sexual and Reproductive Health and Rights (Maputo Plan of Action). Addis Adaba, Ethiopia: African Union Commission.
Coleman, E. (2002). 'Promoting sexual health and responsible sexual behavior: An introduction'. Journal of Sex Research, 39(1), 3-6.
Coleman, E. (2010). From sexology to sexual health. In P. Aggleton, and R. Parker (Eds.), Routledge International Handbook of Sexuality, Health and Rights:. London: Routledge.
Ministers of Health and Education in Latin America and the Caribbean (2008). Ministerial Declaration: 1st Meeting of Ministers of Health and Education to Stop HIV and STIs in Latin America and the Caribbean to Stop HIV and STIs: Preventing Through Education.
World Association for Sexual Health (2008). Sexual Health for the Millennium Declaration.
PHOTO: Ligia Peralta, Eli Coleman, Luis Perelman
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