1. Practical Aspects of Sexual Education
S. Ozalp,
T. Bombas,
M.Joao Trindade,
F. Branco
Why are teenagers still getting pregnant?
Adolescents: pregnancy, parenting, prevention
6th Seminar, ESC, 8 Oct. 2001, Coimbra

2. Prof. Dr. S. Sinan ÖZALP Osmangazi University Faculty of Medicine Department of Obstetrics and Gynecology Eskişehir TURKEY

3. Sexual Education for Adolescents is a Human Right
Young people, as all human beings, have the right to experience and fully develop their sexuality, as well as the right to highest attainable standard of sexual education and reproductive health.
A good and well planned school curriculum, which must include sexual education, will certainly bring more choices possibilities for the young people.
The youth need to be equipped with the skills, tools and knowledge that will enable them to face the future with confidence, responsibility and hope.

4. Definition of Sexual Education
Comprehensive sexuality education is a
consciously planned, usually formal process for
teaching about the biological, psychological,
sociocultural, and spiritual aspects of human
sexuality, and for developing the skills and attitudes
necessary for a positive and healthy sexual life.
Sexuality education approaches sexuality as a
natural, positive, and healthy part of human life and
addresses the pleasures and joys of human sexuality
as well as its undesirable aspects, such as sexual
violence or sexually transmitted infections (STIs).

5. Aims of Sexual Education
Provide accurate information on all aspects of human sexuality, including gender
Assist people to consciously explore, consider, question affirm, and develop their own feelings, attitudes, and values on the various dimensions of sexuality.

6. Aims of Sexual Education
Enhance self-esteem and social skills for developing mutually satisfying, supportive, equitable, and loving intimate relationships, and for self determination in the experience of one’s sexuality, including the expression of one’s gender, and control of one’s reproduction
Enable women and men to responsibly in the expression of their sexuality, in their reproductive behavior, and in their intimate and social relationships.

7. Sex Education: Reasons of Dissatisfaction
In practice many claim they learn more from friends than from teachers
They also complain that when do get sex education, it focuses on biology, issues such as feelings, relationships, homosexuality and sexual decision-making are often omitted
For many young people most learning is still acquired through sexual experience rather than through sex education.

8. Sex Education I was uncomfortable and the teacher was uncomfortable
The way it was, I would have preferred not to have even had it.
It was embarrassing.

9. Constraints
The question of morality.
Teachers face a real dilemma as to how to approach the issues of sexual morality and family life.
Not developing a climate in the classroom in which young people feel safe to discuss their feelings
Sexless course about sexless behaviour in a sexless society

10. Effects of Cultural Values Religious Beliefs Community leaders Friends
Family Members
School teachers
Cultural Values
Religious Beliefs

11. Where Do Young People Learn About Sex?
Debate: Whether schools should teach or leave that to families.
Reality: They learn sex not from their schools or families but instead from their friends, other peers, and books, magazines, and the mass media.
Reality: Much of the information young people learn from these sources is misleading, incomplete, or wrong.
Reality: They learned too little, too late.

12. Sex Education From School Programs
Education in the school curriculum.
The quality, extent and content of courses vary wildly.
Problem: Poor understanding of reproductive biology or contraception.
Problem: Teach only the biology of sex and omit important information about sexuality and preventing pregnancy.
Problem: Schoolbased programs, at the secondary-school level, can not reach those who begin sex earlier or who drop out or never attend school.

13. Sex Education From Parents and Other Family Members
Policy- makers, program managers, and parents themselves often agree that parents are the preferred providers.
Reality: In many societies few parents talk to their children about sex.
Problem: May not receive accurate or complete information.

14. Parents’ Approach to Sex Education
They must be well-informed.
They must talk with their children about reproductive health and sexual responsibility and answer all their questions fully and accurately
Listen to their children compassionately, without dismissing their concerns as childish or condemning their questions as improper

15. Sex Education From Peers and Friends
For some young people, friends are the primary or only source of such information
Because friends and peers are so influential, some health programs are training young people to work as peer educators

16. Sex Education From Mass Media
Source: TV, radio, books, and popular magazines, “adult” movies.
Problem: Entertainment media imply that sex is largely risk free, that everyone is doing it, and that planning for protection spoils romance.
Solution: To counter common mass-media images of sex through appealing and entertaining programming that present more responsible and realistic models for healthy behavior.

17. The Mass Media Approach to Sex Education
Stop glorifying irresponsible sex
In entertainment, depict people who benefit form using contraceptives
In news coverage and other informational formats, provide accurate information and healthy guidance about reproductive health and contraceptives
Make the public aware of young people’s health needs

18. Political Leaders Approach to Sex Education
Political leaders can enact and enforce laws and policies that improve young people’s access to reproductive health information and services
Insist that the news and entertainment media provide more responsible coverage and treatment of sexual behavior

19. Community and Religious Leaders Approach to Sex Education
Advocate and organize substantial reproductive health programs in schools
Call for for responsible depiction of sexuality in the mass media

20. Ten Elements of Effective Sexuality Education
1.The program presents a positive, accurate, and comprehensive view of human sexuality.
2.The program respects and empowers students.
3.The program respects cultural and sexually pluralism and promotes universal values.
4.The program addresses a diversity of learning styles and abilities.
5.The program addresses all three learning domains: cognitive, affective, and behavioral.

21. Ten Elements of Effective Sexuality Education
6.The program is interdisciplinary and integrated across the curriculum.
7.The curriculum is comprehensive in scope, age-and experience- appropriate, and logically sequential.
8.The program is supported and reinforce by the family, peers, religious groups, reproductive health clinics, and local media.
9.The teachers are willing, comfortable, and well-trained.
10.The program promotes lifelong learning.
Evonne Hedgepeth and Joan Helmich,Teaching about Sexuality and HIV:Principles and Methods for Effective Education, NewYork, New York University Press,1996,pp,14-38.

22. Request from the Adolescents
Not only the improvement of the educational
system, but also the inclusion of comprehensive,
non-judgmental, reliable, youth friendly and
responsive to the different needs of young people
sexual education in school curricula.
These programs should be developed, implemented
and evaluated by young people.
Such information and education should address
gender relations and equality, responsibility for one
self as well as for partners; sexuality and freedom of
expression

23. Request from the Adolescents
Young people, as all human beings, have the right to experience and fully develop their sexuality, as well as the right to highest attainable standard of sexual education and reproductive health.
A good and well planned school curriculum, which must include sexual education, will certainly bring more choices possibilities for the young people.
The youth need to be equipped with the skills, tools and knowledge that will enable them to face the future with confidence, responsibility and hope.
A good and well-planned school curriculum, which must include sexual education, will certainly bring more choices for the young people.

24. Adolescents should be actively involved in the planning, implementation and evaluation of development activities that have a direct impact on their daily lives. This is especially important with respect to services concerning reproductive and sexual health.

25. Sex Education Programs Involving the Adolescents
Discussions and activities work better than classroom-type lectures
A workshop approach allows young people to explore their own attitudes and feelings and make discoveries for themselves, and gain the confidence to make their own decisions regarding sexual behaviour, including the confidence to delay a sexual relationship until they are ready
Plays, songs, radio shows and other popular communication methods are also useful.

26. Speak to adolescents in their own language and through their own lines of communication such as TV shows they watch, etc.
Whenever there were points raised about the specific needs and problems, it must be put forwarded by adolescents themselves.

27. Adolescents Approach
Work with parents, community leaders, teachers, and health care providers to design mutually acceptable approaches to meeting their own reproductive health needs
Act responsibly in sexual matters, for their own sake and that of others
In sexual situations, respect the rights, wishes, and concerns of others, including use of contraceptives to avoid unwanted pregnancies and of condoms for STD protection.

28. What is Good Sex Education
Building self-esteem and self- confidence
Provide the opportunity to acquire accurate information
Allowing to clarify attitudes and values and explore potential consequences of decisions they might make
Encouraging young people to develop a sense of responsibility for their own sexual health and respect for the feelings, values and well-being of others
Enabling young people to develop the communication and personal skills that are necessary for building and maintaining relationships as friend, partner, parent and family member.

29. Qualifications of Sexuality Educators
Untrained sexuality educators often believe that they know more than they do,and do not realize the importance of specialized expertise.
Not just adolescents, but educators,need to identify and work through their own attitudes and values, biases and prejudices.
Developing expertise in sexuality education takes training,practice feedback, supervision, refresher training, and time.
 Providing reference materials to educators on sexuality and sexuality education is a simple, essential step.
Sexuality educators must be carefully selected.
Not everyone is suitable!

30. Educators Approach to Sex Education
Develop school curricula that give students age appropriate information about reproductive health
Train and support teachers so that they can teach about reproductive health and contraception accurately and comfortably
Facilitate better communication about sexuality and contraception between students and their parents.

31. Leaders of Reproductive Health Programs Approach to Sex Education
Provide information and services at times and in ways that are acceptable and convenient
Remove other unnecessary barriers to services, including limits on access to contraceptives for reasons of age or marital status;
Help the mass media inform the public about sexuality and reproduction accurately and encourage the entertainment media to depict sexual behavior responsibly; and
Know where to refer young people for more information and health services.

32. Leaders of Reproductive Health Programs Approach to Sex Education
Establish health care protocols that meet the needs of young adults
Be sensitive to the concerns of the community while acting as advocates for meeting young adults’ needs
Involve young people in program design, delivery, and evaluation;
Train health care providers to offer high quality care to young adults in a nonjudgmental, confidential manner

33. Results of Sexual Education
Increases in sexual knowledge and personal comfort with sexuality
Increased tolerance toward the behaviors and personal values of others
Delay in the onset of onset of sexual intercourse and increased likelihood of using contraception when individuals do begin having intercourse
Increased communication with parents about sexual matters, which correlates with more responsible behavior
Increased self-esteem and decision-making skills.
Evonne Hedgepeth and Joan Helmich,Teaching about Sexuality and HIV; Principles and Methods for Effective Education, New York:New York University Press, 1996, p.3.

34. Results of Sexual Education
Does not lead to increased sexual activity
No evidence that sex education in schools leads to earlier or increased sexual activity in young people
Sex education resulted in either delayed sexual activity or decreased overall sexual activity  
Access to counseling and contraceptive services did not encourage earlier or increased sexual activity
Sex education increased the adoption of safer sexual practices among sexually active youth  
Sexuality Education Does Not Lead to Increased Sexual Activity.Press Release,26 November Geneva: WHO,1993

35. Sex Education is a Complex Process
Gather information
Observe the behavior of peers and other people
Develop attitudes and values
Experiment with behavior
Rely on different sources for sex information during different stages of life.

36. What shall we do now?

37. IPPF Charter on Sexual and Reproductive Rights, 1996
 All persons have the right to equal access to education and information to ensure their health and well-being, including access to information, advice and services relating to their sexual and reproductive health and rights. All persons have the right to access to education and correct information related to their sexual and reproductive health, rights and responsibilities
IPPF Charter on Sexual and Reproductive Rights, 1996

38. IPPF Charter on Sexual and Reproductive Rights, 1996
 All persons have the right to sufficient education and information to ensure that any decisions they make related to their sexual and reproductive life are made with full, free and informed consent.  All women have the right to information, education and services necessary for the protection of reproductive health safe motherhood and safe abortion and which are accessible, affordable, acceptable and convenient to all users.
IPPF Charter on Sexual and Reproductive Rights, 1996

39. Family Planning Association of Turkey (FPAT)
Runs four model clinics in different cities, and conducts four community-based health service projects for marginal groups and deprived urban communities where there is a high level of unmet need. These projects aim to assist local communities to mobilize their own resources to promote reproductive health care and contraceptive use, and include education programs for women and young girls especially.

40. FPAT Through its 23 branches, the Association conducts
information, education and communication (IEC)
activities in urban and rural areas, focusing
especially on activities for young people and male
involvement, for example, through programs for
military conscripts. The FPA has organized young
peoples' panels discussions in order to assess
priorities in sex education. It runs two youth sexual
health projects and has set up a Youth Group. The
FPA broadcasts a weekly radio and TV programs
`Healthy Family - Happy Society', with audience
feedback.

41. There is a great difference in sexuality
between boys and girls?
norms and values are given to sexuality.
Norms and values influence policy and programs, leading to more inequality and discrimination against women.

42. Maybe make it a serious class you need a grade in, in order to graduate, to make it really mean something. It may be opposed in some places, like by religious organization not letting this information come through, but then special programs could be establish by government to oversee the implementation of sex education, so that it's done right.
Maybe a law was passed, but not enough is being done to make it happen.
Keeping information from young people is very dangerous.