Commentary: Sexuality Education that Develops Sexual Intelligence in Youth

Commentary: Sexuality Education that Develops Sexual Intelligence in Youth

A research-informed, responsible, relevant and realistic youth-centric approach

By Focus on the Family Singapore | 31 Aug 2020

There has been much discussion about what kind of sexuality education youth should receive. More specifically, the question of whether they should be taught premarital abstinence or the use of contraception constantly comes under the spotlight, and these days, the debate has also turned towards the issue of consent and gender identity.

Some believe that youth should only be educated to reserve sexual activity for marriage, and worry that teaching young people about contraception would make them more likely to have sex prematurely (i.e. Abstinence-Only Sexuality Education). Others are of the opinion that youth are going to be sexually active anyway and must be guided on how to avoid out-of-wedlock pregnancy and protect themselves from sexually-transmitted diseases; thereby viewing abstinence-only education as unrealistic and out of step with the times (i.e. Safe Sex or Comprehensive Sexuality Education).

A thoughtful approach to this issue should take into foremost consideration the target audience of sexuality education: the youth themselves.

The developmental needs of youth

  1. The youth brain needs time to be fully developed
    Studies have shown that the human brain will only complete its development between the ages of 25 and 30. Our children thus do not yet have the neurobiological capacity to make fully mature or wise decisions until their mid-twenties, simply because their limbic system (the emotional brain) is much more developed than their pre-frontal cortex (the rational brain)1.

    In the face of emotions and desires that they experience powerfully during adolescence, teenagers are likely to not be able to accurately assess risks and anticipate the consequences of their actions2. When they find themselves in emotionally charged situations, their more mature limbic system tends to win over their (presently) less developed pre-frontal control system, and this increases the likelihood of them engaging in risky behaviour3.
  2. Youth need input from parents and trusted mentors
    Due to their neurobiological development, young people need the help of parents and teachers or trusted adults to learn how to make rational decisions through repeated, clear and consistent guidance4. Parents, in particular, should be the primary people to teach their children sexuality education, according to their own family values (which includes faith traditions, if any). This is in line with one of the Ministry of Education’s 6 Guiding Principles of Sexuality Education5.
    Parents have the best interests of their children at heart, understand what their kids are ready to learn about, and are best placed to initiate and sustain ongoing conversations with them on sexuality in the context of a safe parent-child relationship. Contrary to popular belief, in a local survey of 5,122 young people, around 80% of them cited that parents should be the primary source of sexuality education, above school (7%), the Internet (1%) and friends (1%), even though only 15% reported personally experiencing it6.
  3. Youth need the good of peer influence
    Peers can also have a significant impact on youth sexual behaviour—for good or ill. Studies have found that students with friends who use substances or alcohol tend to increase their use, but those who participated in peer-led programmes to reduce substance or alcohol use are more likely to decrease their use7 8. The same applies to sexual behaviour. In fact, youth who perceive that their peers are engaging in sexual activity are more likely to do so themselves9, with their first sexual encounter happening at a younger age10. This link between youth’s perception of their peers’ sexual behaviour and their own sexual behaviour holds true, especially for boys, across different cultures11.

    Understanding brain development, it is not surprising that teenagers experience more social anxiety about feeling left out (in teen speak: “FOMO” or Fear Of Missing Out”) or not belonging, and they may behave in certain ways in order to avoid that feeling. As they become more self-aware at this stage, they also worry more about what others think about them, which can lead them to be more vulnerable to certain type of negative influences2.

The need for youth-centric sexuality education

Since adolescents tend to find it more difficult than adults to make logical decisions in the midst of strong emotions and desires, how can sexuality education help young people avoid having their powerful sexual feelings lead them to make choices they later regret?

In view of youth’s developmental needs, the type of sexuality education that best serves them is one that can equip them — together with their community of peers — with age-appropriate information and handles. Youth-centric sexuality education should be geared toward developing sexual intelligence in young people, so that they are empowered to make smart sexual decisions that benefit them and others, both in the short-term and the long run. In fact, sexuality education that enables them to postpone their first sexual encounter to a later age, when they can fully understand the consequences of their decisions, would produce better outcomes for young people.

Teaching contraception and consent in sexuality education

Teach the realistic and holistic truth about condoms
Those who advocate teaching youth to use contraception are concerned about protecting them from sexually transmitted infections (STIs) and unintended pregnancies. Taking the most common contraception – condoms, how effective is this approach?

How effective are condoms?

  • There are, at best, conflicting findings on the effectiveness of condoms in preventing STIs and unintended pregnancies12 13.
  • While correct and consistent use of condoms provides a high level of protection against most STIs, this is not typical of real-life situations. Condom usage errors, breakages and slippages are common worldwide, occurring in as many as 40% of sexual encounters14.
  • When it comes to HIV transmission, consistent condom usage with the same partner provides only around 71-77% protection15.
  • Because condoms cannot cover all infected areas of the body, they do not protect against STIs that spread through skin-to-skin contact, such as syphilis, herpes, human papillomavirus (to which the World Health Organization attributes nearly all cases of cervical cancer 16), genital warts, molluscum contagiosum virus, chancroid, etc.
  • While correct and consistent use of condoms are 98% effective in preventing unintended pregnancies, imperfect real-life condom usage yields only about 82–85% effectiveness. That means that there is around 15–18% pregnancy rate even with the use of condoms14 17.

So will intentionally teaching youth how to use condoms ensure their consistent and correct usage, or does it have the unintended effect of encouraging them to engage in risky sexual behaviour due to their underdeveloped pre-frontal lobes? There is a phenomena called risk compensation: people tend to lower their guard and are more willing to engage in risky behaviour when they believe that their risk has been reduced by technology18. For example, people who use sunscreen tend to stay longer in the sun19 and traffic-related deaths increased after compulsory seatbelt laws were introduced20. A feeling of one’s vulnerability being lowered leads to a rise in careless behaviour.

Similarly, sexuality education that has an emphasis in promoting condom usage can inadvertently increase—instead of decrease— sexual activity (including multiple sexual partners) and unprotected sexual exposure (due to inconsistent and incorrect, or “careless”, usage) among youth21 22. It has been found that up to 1 in 3 young men in Singapore chose not to use condoms mainly due to the reduced pleasure they experienced23.

In other words, sexuality education that focuses on contraception use, coupled with youth’s lower ability to assess risk accurately, can lead to youths:
  • having sex earlier
  • having more sexual partners
  • engaging in more risky sexual behaviour
  • experiencing an increased risk of contracting STIs
  • facing a higher likelihood of sex resulting in unintended pregnancies

On the other hand, there are those who advocate for sexuality education that excludes any mention of condoms, out of concern that teaching youths about condoms encourages them to have sex. We need to acknowledge that in this digital age when most youth can access all kinds of information from social media and online platforms that are hard to regulate or censor, it is highly likely that they would already receive some kind of information about condoms – whether or not it is accurate or holistic.

Thus, it is only responsible to fully inform youth of these facts about contraception:

  1. Even correct and consistent usage do not guarantee 100% protection against STI transmissions or unintended pregnancies.
  2. Imperfect condom usage is not uncommon, even among adults, so what more among inexperienced youth users who are already neurobiologically not as able to make fully rational choices, especially when they are caught up in the heat of sexually-charged moments.

This should cause us to rethink sexuality education that focuses on contraception use.

It is noteworthy that, instead of condom promotion, 150 global AIDS experts came together to advocate for an evidence-based approach to prevent HIV/AIDS transmission by adopting the A-B-C method: Abstain, Be faithful/reduce partners, use Condoms22, in that order.

Teach proper consent informed by values
Proponents of teaching youth how to use contraception in sexuality education often also advocate for consent education, especially given the recent rise of sexual assault cases in the news. Consent education assumes that when more young people understand what informed consent means and how to respect their partner’s verbalised boundaries, this will mitigate instances in which the sexual boundaries are coercively transgressed.

While teaching youth about informed consent is important, it is insufficient in itself.

A behaviour does not become beneficial to youth simply because all the parties involved consent to it. In the complex dynamics of relationships and real-life situations, it is not unthinkable to agree to something even against one’s better judgement. Considering adolescents’ (lack of) neurobiological capacity for making rational decisions, assessing risks and predicting the consequences of their actions as well as their anxiety-driven desire for acceptance and belonging, teenagers may all the more find themselves consenting to participate in something that is not objectively good for them nor for their partner.

Effective consent education thus needs to factor in an objective benchmark by which to assess whether a behaviour is positive or harmful—and that makes teaching of values an indispensable part of any sexuality education that considers youth’s holistic well-being. Sexual decision-making should include factual information about healthy emotional, physical and psychological boundaries, based on universal virtues of integrity, love and respect (for self and others) as well as character traits of self-regulation, responsibility and resilience. Furthermore, it ought to include parental rights to educate their children about sexual decisions and boundaries according to their family and faith values.

Teaching abstinence in sexuality education

  1. Sexual abstinence is research-informed
    What, then, is the more responsible approach: teaching youth risk reduction (until they have the ability to fully understand their actions) or risk elimination (given their current developmental stage)?

    An evidence-based youth-centric approach to sexuality education entails informing youth that abstaining from all sexual activity (until marriage) is the 100% safest and most effective way to protect themselves from the negative physical, emotional, and psychological consequences of adolescent sexual activity.
  2. Sexual abstinence is responsible
    At a time of their lives when young people are not yet fully capable of accurately assessing risk and anticipating consequences, they should be taught to avoid risk rather than to reduce risk.

    Intoxicated people are not completely able to make rational decisions because their executive functions have been impaired by the effects of alcohol. Is it safer for them—and others—to teach them how to wear seatbelts properly while driving (risk reduction) or to instruct them to not drive at all (risk elimination)? To be sure, they should be made aware of seatbelts, but the more responsible thing to do is to educate them to not get behind the steering wheel if they wish to drink.

    As adults—parents and/or educators—it is our responsibility to ensure our children/youth avoid sexual risk altogether. They are too precious for us to allow them to take a gamble with their lives and sexual well-being.
  3. Sexual abstinence is relevant
    As mental health challenges faced by youth in Singapore today are on the rise24, abstinence has never been a more important and sexually intelligent choice for youth. It is not only a foolproof way to prevent STIs and pregnancies, it also safeguards young people’s emotional and mental well-being.

    Sexual activity and mental wellness
    • Teenage sexual activity has been found to be an independent risk factor for developing poor self-esteem, major depression, and attempting suicide25.
    • Compared to sexually abstinent girls, sexually active girls were three times as likely to suffer from depression and to have attempted suicide26.
    • Compared to sexually abstinent boys, sexually active boys were more than twice as likely to suffer from depression and seven times more likely to have attempted suicideibid..
    • 67% of girls and 53% of boys regretted becoming sexually active too early27. Sexual regret has been associated with negative psychological outcomes, like loss of life satisfaction, loss of self-worth and depression28.
    The chemicals released in the brain during sexual activity create emotional bonds between sexual partners, and breaking these bonds can lead to depression and make it more difficult for them to bond with someone else, like their spouse, in future26.

    Despite divorce being on the rise, young people in Singapore still have high aspirations towards marriage and family formation with 83% indicating that they intend to marry29 and around 35% citing getting married and having children as important life goals30. Youth should therefore be informed that sexual abstinence until marriage can increase their chances of experiencing a better quality of life and stronger quality of marriage.

    Sexual abstinence and future marriage
    • Compared to those who had sex with other people before marriage, men and women who only had sex with the person they married reported higher quality of marriage31.
    • For women, in particular, the more sexual partners they had before marriage, the less happy they reported their marriage to beibid.
    • Compared to couples who had sex early on in their relationship, couples who waited until marriage to have sex reported higher relationship quality and satisfaction, better sexual quality and better communication.32
  4. Sexual abstinence is realistic
    There are some who find sexual abstinence an archaic concept and purport that teaching youth to abstain until marriage is unrealistic, whether because of hormones, family background, situational circumstances or previous experience. However, the facts suggest otherwise.
    • Well-designed and well-implemented abstinence education programmes have been found to result in delayed sexual initiation, reduced early sexual activity33, and significant long-term decrease in teenage sexual activity34
    • Sexually experienced young men in Singapore who went through an abstinence and safer sex intervention programme were twice as likely than those who did not attend the programme to report being able to exercise better self-control and abstain from sexual activity by practising the strategies they learnt23.

    Consistent with studies in America, a local study found that students in Singapore tend to overestimate their peers’ sexual permissiveness, with the sexually active students using this misperception of the prevalence of sexual activity among their peers to justify their own sexual permissiveness; actually, most respondents held sexually conservative attitudes35. In other words, sexual abstinence may be more of a norm than we think and a more realistic expectation of youth sexual attitudes and behaviours.

    Focus on the Family worldwide has in the past 2 decades reached millions with the A-B-C approach to sexuality education that emphasises and prioritises abstinence, and continues to be welcomed in communities by both youth and parents/educators. For youth who have been previously sexually active, helping them to live out a (re)commitment to sexual abstinence can be very empowering and provide a newfound sexual freedom.

Conclusion

In determining the best approach to sexuality education today, we need to evaluate what best develops sexual intelligence in our young. Sexuality education that is research-informed, responsible, relevant and realistic for youth is one that takes into account their developmental stage and needs, so that they can be given the best age-appropriate handles to make sexually intelligent decisions. It entails giving them the full information on abstinence, consent, and contraception, while teaching them to take the approach of risk avoidance or elimination. Such an approach ultimately conduces to the best outcomes for the short- and longer-term health and well-being of our children.

References:

  1. The Primal Teen: What the New Discoveries about the Teenage Brain Tell Us about Our Kids (2004)
  2. That teenage feeling (2007)
  3. The adolescent brain (2008)
  4. Abstinence education (2014)
  5. Sexuality education: Overview
  6. Whole Life Inventory (2016–2018)
  7. Peer Participation in Project Northland: A Community‐Wide Alcohol Use Prevention Project (1994)
  8. Peer acceleration: effects of a social network tailored substance abuse prevention program among high‐risk adolescents (2007)
  9. Adolescent Susceptibility to Peer Influence in Sexual Situations (2016)
  10. Perceived Peer Behavior and the Timing of Sexual Debut in Rwanda: A Survival Analysis of Youth Data (2004)
  11. Meta-analysis of the relations between three types of peer norms and adolescent sexual behaviour (2014)
  12. Abstinence education (2014)
  13. Effectiveness of condoms in preventing sexually transmitted infections (2004)
  14. Condom use errors and problems: a global view (2012)
  15. Condom effectiveness in reducing heterosexual HIV transmission: a systematic review and meta-analysis of studies on HIV serodiscordant couples (2015)
  16. Human papillomavirus (HPV) and cervical cancer (2019)
  17. Condom Use by Adolescents (2013)
  18. Rethinking AIDS Prevention: Learning from Successes in Developing Countries (2003)
  19. Risk compensation: the Achilles' heel of innovations in HIV prevention? (2006)
  20. https://www.researchgate.net/publication/12648903_Condoms_and_seat_belts_The_parallels_and_the_lessons (2000)
  21. Increasing condom use without reducing HIV risk: results of a controlled community trial in Uganda (2005)
  22. The time has come for common ground on preventing sexual transmission of HIV (2004)
  23. Randomized controlled trial of abstinence and safer sex intervention for adolescents in Singapore: 6-month follow-up (2017)
  24. National Youth Council’s Y+ e-newsletter – Youths & Mental Health (2019)
  25. Adolescent depression and suicide risk: association with sex and drug behavior (2004)
  26. Hooked: New Science on How Casual Sex is Affecting Our Children (2008)
  27. With One Voice 2012: America’s Adults and Teens Sound Off About Teen Pregnancy (2012)
  28. Risky business: Is there an association between casual sex and mental health among emerging adults? (2014)
  29. Marriage and Parenthood Survey (2016)
  30. The State of Youth in Singapore (2017)
  31. Before “I Do”: What Do Premarital Experiences Have to Do with Marital Quality Among Today's Young Adults? (2014)
  32. Couples who delay having sex get benefits later, study suggests (2010)
  33. Abstinence Education: Assessing the Evidence (2008)
  34. “Abstinence” or “Comprehensive” Sex Education?— The Mathematica Study in Context (2007)
  35. Pluralistic Ignorance About Sex: The Direct and the Indirect Effects of Media Consumption on College Students’ Misperception of Sex-Related Peer Norms (2007)

© 2020 Focus on the Family Singapore. All rights reserved.

 

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