In their own voices: Effective sexual health education beginning with youth wants, needs and agency

by Michael Lyons

The following is my essay reviewing literature of Canadian and Ontario studies about young people’s wants and needs, parents perceptions and discrepancies between the two around sexual health education in the province. Given that ideological- over fact-based arguments have started cropping up in the media, I wanted to share this publicly to show that parents want their children to receive a progressive sexual health education in public schools, no matter what the vocal minority shouts, and that young people have ideas about the kind of sexual health education they want to receive.

I’m relying on Tina Belcher from popular cartoon Bob’s Burgers as inspiration in this endeavor.

Lia Valente and Tessa Hill, two young women in grade 8, want to make sure consent is explicitly part of the discussion when Ontario receives a promised and much needed update to the province’s sexual health education (SHE) curriculum.

As it stands, Ontario’s current Health and Physical Education (H&PE) curriculum, which encompasses SHE, has not been updated since 1998. In 2010, an updated and revised elementary H&PE curriculum was introduced, but the provincial government withdrew the “Human Development and Sexual Health” component, and withheld the entire secondary H&PE curriculum, which affects 2.1 million students and their families (Sears and Markham). Ophea, an organization that promotes healthy, active living in Ontario schools and communities, writes, “We believe that the updated 2010 curricula were the subject of an often misinformed and ideologically charged debate that misrepresented their content and intent.”  (“Addressing…”)

In late October of 2014, the provincial government promised updates to the curricula would be reintroduced and implemented by September 2015, and already ideology-based arguments against the updates are appearing in the media, coming from a Toronto-area teacher with the Ontario English Catholic Teachers Association (Smol) and an anti-gay evangelical Christian preacher. (Warmington) These misinformed, values-based arguments disproportionately hold sway over the public and government officials despite the fact that they are in direct opposition to the belief of the majority of parents in Canada. Furthermore, they fail to take into account the wants, needs and agency of young people, like Valente and Hill, especially those from diverse communities, in regards to the SHE youth are going through. In this research paper I will review recent literature on attitudes towards SHE from Canadian and Ontario studies. I will focus specifically on what youth want out of SHE and sexual health resources, what parents want in regards to a strategy for SHE and missing elements in the discourse surround SHE. In this regard I hope to offer a fact-based snapshot of attitudes toward the current and proposed SHE, and offer ideas for a youth-focused, sex-positive SHE curriculum.

What do young people say?

The Toronto Teen Survey (TTS) was a community-based, youth-involved participatory research initiative sponsored and carried out by Planned Parenthood Toronto, Ontario universities and Toronto Public Health. Surveys were gathered from 1,216 Toronto youth (13-18+) with a focus on sexually- and racially-diverse communities. “As one of the largest and most diverse studies of young people’s sexual health needs ever done in Canada, TTS provided a space for youth voices that are often unheard.” (4)

The key findings in the information-dense results explore a number of elements of participants’ sexual experience. “Toronto teens are engaged in a wide variety of sexual behaviours: 69% of participants reported kissing a partner, 25% reported giving or receiving oral sex, 27% reported vaginal intercourse and 7% reported anal sex. Twenty-four percent said they had never engaged in any sexual experiences.” (5)

Based on data, youth who were more likely to have accessed sexual health services were sexually active, female, older, white and sexually diverse (lesbian, gay, bisexual, two-spirited, pan-sexual or queer), whereas male, younger, Black, Asian, Aboriginal and Muslin youth were less likely to access services. (18) From those surveyed, 92% of youth had received some form of SHE, while 8% had received none at all. Newcomer youth were at the most significant risk of missing SHE, especially if they did not receive it in high school. (6)

A final, significant element of the TTS describes the disconnect between what youth are learning and what they want to learn:

The top three sexual health topics youth have learned about are HIV/AIDS, STIs, and pregnancy and birth control. […] Healthy relationships, HIV/AIDS and sexual pleasure are the top three sexual health topics youth want to learn more about. This differs from what youth are actually learning: less than 30% of the diverse youth populations surveyed reported they have learned about healthy relationships and no group included sexual pleasure in their list of top three topics learned. (6)

While the survey notes because of the specific targets of participants it cannot be generalized, the TTS strength is that it focuses on the experiences and needs of youth from diverse communities, especially Black (African/Canadian/Caribbean) and Asian (East/South) youth. (11-12). The findings compliment other studies, like one about substance use and risky behaviour referenced by Ophea. The organization points out that “students are having sex, curriculum or no curriculum. According to a 2010 survey of Canadian students, just over a quarter of male students and just under a quarter of female students reported having had sex by grade 9 or 10. Twenty-five percent of those who responded as having had sex did not use a condom.” (“Sexual Health…” 3) Published in 2011, this cross-national survey further describes that “[among] these Grade 9 and 10 students, 6% percent of boys and 2% of girls reported first having sexual intercourse when they were 12 years old or younger.” (Public Health Agency of Canada 157)

While abstinence and risk avoidance are the main strategies of the current SHE curriculum, given the rate at which youth are engaging in low to high risk sexual behaviour, at the ages they do, and on a number of other factors, the system does not reflect reality and is failing young people.

What do parents say?

The majority of parents, both provincially and nationally want SHE taught in public schools, and they want an up-to-date SHE curriculum to be taught. At the provincial level, 87% of parents either agree (42%) or strongly agree (45%) that SHE be a provision of health education in public schools, based on a 2014 study of 1,001 parents with students in an Ontario public school. (McKay et al. 161) This study was based on a series of studies seeking a similar answer, and summarizes their findings for comparison:

  • A 1998 study conducted by researchers in southern Ontario found that 95% of parents strongly agreed or agreed that SHE should be provided in the school system
  • A 2002 study in New Brunswick study found that 94% of parents strongly agreed or agreed that SHE should be provided in the school system
  • A 2008 study in Saskatchewan found that 92% of parents strongly agreed or agreed that SHE should be provided in the school system (McKay et al. 160)

Surveys can only offer a snapshot of attitudes, but in all recent instances, from population centres, to the prairies and the Maritimes, the vast majority of parents believe SHE should be taught in schools. McKay’s study also details how, in each study, a significant number of parents believe SHE should be started in elementary school, and a majority believe it should be started in middle school (grades 6-8). (160-161)

Returning to findings specifically from McKay’s 2014 study, “About a third of parents (34%) rated the SHE their child had received as very good or excellent. About a third of parents (34%) rated it as fair or poor. Finally, most parents (93%) felt it was important or very important that their children learn from a SHE curriculum that was more up-to-date.” (161)

McKay notes that in previous work the study referenced:

Weaver et al. also explored how parents provided SHE at home. Most striking was the finding that “despite their stated desire to do so, many parent indicated that they were providing ‘little or no SHE to their children’” (p. 30). Parents who were more supportive of school-based SHE provded better quality SHE to their children at home, demonstrating the synergy between school-based and home-based SHE (Byers, Sears, & Weaver, 2008). (McKay 160)

McKay also notes that a limitation of the study is that survey respondents were “disproportionately well-educated, middle to upper-middle income, and disproportionately mothers rather than fathers.” (McKay 166) Comparing this to the TTS paints a picture of the attitudes of less diverse middle-class parents over more diverse urban youth toward SHE.

The same study finds that parents rate a broad range of topics as “very important,” including issues such as “skills for healthy relationships,” “decision making skills” and “communication skills,” which are comparable to healthy relationships that youth in the TTS wanted to learn about, and “sexually transmitted infections,” comparable to HIV/AIDS. The parents were not asked about sexual pleasure, which the TTS participants listed as one of the top three SHE issues they wanted to learn about. “Media literacy” stood alone as the only topic parents considered important (rather than very important). Parents considered “abstinence” as a topic that was very important for their children to learn about in regards to SHE.

The conversation that isn’t happening

There is a significant discrepancy over the kind of SHE youth want compared to what they’re getting and, as previously mentioned, the system in place is failing youth in regards to several factors. Ophea explains that, as it stands, Ontario’s 1998 curriculum, along with those of several other provinces, holds abstinence, education about STIs and HIV/AIDS and risk prevention as the central tenants around healthy sexuality. (“Sexual Health…” 11) Across the board, literature surrounding the Ontario SHE curriculum describes the current strategy as focusing on “avoiding negative outcomes, such as sexually transmitted infections or unwanted pregnancies.” (Meaney et al. 108) Even in the updated curriculum as proposed by the provincial government in 2010, “Students are expected to develop an understanding of reproductive systems, the possible consequences of risky behaviours, pregnancy and disease prevention, and abstinence as a positive choice for adolescents.” (168) Issues of sexual harassment and gender-based violence/harassment are discussed, but the word “consent” does not appear at all within the 219-page 2010 H&PE update.

As previously detailed, this strategy is not keeping youth from engaging in low to high-risk sexual behaviour. Furthermore, the TTS notes:

Rates for chlamydia, gonorrhea, and syphilis have increased steadily among Toronto youth since 2001, and in Canada are highest among those aged 15 to 19. […] An increase in youth HIV infection rates, especially in adolescent females, and this recent surge in STIs are signs of the potential for an increased incidence of HIV among Canadian youth. (8)

Ophea, as well, echoes these facts, and the focus on risk aversion and abstinence is being challenged by researchers, especially as an ideological function. The TTS also did follow-up focus groups with 80 service providers (SPs) from 55 different agencies. Data from the TTS was presented, “including the data on young people’s desire to learn about sexual pleasure.” (Oliver et al. 144) Oliver’s analysis notes conservatism at the federal level has promulgated the “so-called family values” approach, and that conservative backlash was the reason the 2010, well-researched, age-appropriate H&PE updates were shelved. (143)

“Many SPs recognized that sexual pleasure could be used as a catalyst for teaching youth about the full range of sexual health issues – including STIs and fertility: ‘Healthy relationships,’ sexual pleasure is a jumping off point to all the other issues, instead of just focusing on disease’,” (Oliver 144) a Youth in Care SP said during the focus groups. The study of SP-perceptions offers a number of useful insights, including observations that the current sexual agenda prioritizes scripts for girls to fend off sexual advances from boys without addressing desire and the ability to make decisions from personal desire (145). Schools were seen as the best method for distributing SHE, but SPs saw discussing sexual pleasure in the school system as a roadblock. Oliver’s writing notes that a recent Canadian study found the three topics teachers were least willing to teach were sexual pleasure and orgasm, masturbation, and sexual behaviour. (145)

For a variety of reasons, SPs and doctors are not able to offer detailed sexual education to youth, so schools shoulder the burden. McKay’s study found that parents were most comfortable with their children receiving sexual information from themselves — parents — health providers, schools and non-fiction books. They are least comfortable with their children receiving sexual information from their children’s peers, the Internet, social media and other media. (163) This is an enormous discrepancy from young people’s lived experiences: the TTS found that most youth are likely to talk to their friends and health providers when they have a question about sexual health, with young women significantly more likely to talk to health providers (48% would) than young men (36% would). Young women are also more likely to rely on their peers (62% would go to their friends) than young men (41%). Similarly, 37% of young women surveyed would rely on mass media for sexual health information, and only 27% of young men would. Parents seemed to account for only 28% of where youth would go to get their sexual healthy questions answered. (24)

Conclusion

I have identified two elements that are not addressed in Ontario’s SHE, nor in broader issues of sexual health, as it stands:

  • young people want to learn about sexual pleasure (sexual pleasure does not factor into the current or proposed curriculum)
  • young people want to get their sexual health information from their peers, health providers and mass media (parents want their children to get sexual health information from themselves — parents — health providers, school and non-fiction books, and are uncomfortable with their children receiving sexual information from peers and mass media)

These elements amount to one thing that wider society fails to acknowledge: young people have sexual agency. Effective SHE needs to rely on the involvement of parents, teachers, health care providers and a more holistically youth- and sex-positive society as a whole while equipping youth with a system and the tools to educate their peers and positively and safely navigate sexual experiences. Of the TTS survey’s many recommendations, the organization calls for youth involvement on every level of decision-making in regards to SHE curriculum building and implementation. Addressing issues that youth want addressed on every level means shaping their sexual health education and services to address that young people want to learn about things like sexual pleasure, which one SP notes: “I would think the information would have to be given by some peers, not by a stuffy teacher you know.” (Oliver 145)

Valente and Hill are prime examples of youth who took charge when they saw a failing of the system, that being the lack of discussion around consent in SHE. “One way to change this is having discussion in our education systems about consent with boys and girls, knowing that young women between the ages of 16 and 21 are at the highest risk of sexual assault.” (We Give Consent) These two courageous and intelligent youth are already being attacked by a vocal minority on an ideological level, a tactic which can be expected as the provincial government moves to implement the updated new H&PE curriculum. However, from a fact- and research-based standpoint, history is on the side of these young women. Encouragingly, like the youth-driven Toronto Teen Survey, young people are already taking their own education and fulfillment into their own hands, whatever the so-called grown-ups think is best.


Bibliography

Meaney, Glenn, et al. “Satisfaction with school-based sexual health education in a sample of university students recently graduated from Ontario high schools.” The Canadian Journal of Human Sexuality 18.3 (2009): 107-124. Print.

McKay, Alexander, et al. “Ontario parents’ opinions and attitudes towards sexual health education in the schools.” The Canadian Journal of Human Sexuality 23.3 (2014): 159-166. Print.

Oliver, Vanessa, et al. “If You Teach Them, They Will Come: Providers’ Reactions to Incorporating Pleasure Into Youth Sexual Education.” Canadian Journal of Public Health 104.2 (2013): 142-147. Print.

Phillips, Karen and Andrea Martinez. “Sexual and Reproductive Health Education: Contrasting Teachers’, Health Partners’ and Former Students’ Perspectives.” Canadian Journal of Public Health 101.5 (2010): 374-379. Print.

Sears, Heather and Chris Markham. “H&PE op-ed.” Toronto: Ophea. Web.

Smol, Robert. “Sex-ed Offensive.” NOW Magazine. Now Communications Inc. 26 Jan. 2015. Web. 1 Feb. 2015.

Warmington, Joe. “Wynne’s sex ed photo-op raises eyebrows.” Toronto Sun. Sun Media, 27 Jan. 2015. Web. 1 Feb. 2015.

Addressing Human Development and Sexual Health within the Ontario Health and

Physical Education Curriculum. Toronto: Ophea. Web. 1 Feb. 2015.

It’s Time to Take Action for Ontario’s Kids. Toronto: Ophea. Web. 1 Feb. 2015.

Ophea Parent Opinion Survey: Summary of Findings. Toronto: Environics Research Group, 2013. Web. 1 Feb. 2015.

Sexpress: The Toronto Teen Survey Report. Toronto: Planned Parenthood Toronto, 2009. Print.

Sexual Health Education in Schools Across Canada. Toronto: Ophea. Web. 1 Feb. 2015.

The Health of Canada’s Young People: A Mental Health Focus. Ottawa: Public Health Agency of Canada, 2011. Web. 1 Feb. 2015.

The Ontario Curriculum Grades 1-8: Health and Physical Education Interim Edition. Ottawa: The Ministry of Education, 2010. Web. 1 Feb. 2015.

“Make consent a topic in the 2015 Ontario Health Curriculum.” Change.org. We Give Consent, 21 Dec. 2014. Web. 1 Feb. 2015.

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