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Teenage Sex Part 3
Irish Examiner 01/09/2005

by Ailin Quinlan

In the third part of our four-part series on teenagers and sex, Ailin Quinlan examines what students learn in school and how changes could reduce our teen pregnancy rates.

What Some Teens Think

"Magazines are better than the sex education at school, they have a lot of information because they deal with things you don't get in school or don't ask your parents about."

"We got a talk about puberty in first year - it was way too late. We got a talk about sex and contraception and STIs in fourth year - it was way too late also. That was the first we'd heard about STIs, and it was certainly a bit late for some of the girls I know who go out with fellas older than them and have oral sex with them."

"It's just way behind what you need when you need it. What you learned about puberty in school was that boys get hairier, girls get curvier."

"In fourth year, we had a chastity talk. They also talked about mental health, and bereavement. But hese horrible Americans came in and told us why we should practice chastity. Then at age 16 they showed us a video of a woman having a baby, which was awful to look at. But we did have an open-minded teacher who went through sexual health withus. She used the proper names for everything, no slang, which was really great. We weren't used to it."

"There's nothing in national school. I remember we couldn't wait for that chapter in biology. We had no outside services come in, nothing. But it's not a biology teacher's job to talk about feelings. Ours talked rapidly about the reproductive system, said, "We'll save that for just before the Leaving Cert. But we had to know some of it for the exam."

"In national school, we got nothing. Sure, we were all gonna be nuns! They just gave us that talk on, 'These bad people do things to you.' We were like, 'What?' We hadn't a clue what they were going on about."

What shall we tell the children?

Embarrassed teachers, inadepuate information poorly presented in a patchy, sporadic manner - these ared just some of the criticisms of the school sex education programme contained in an as yet unpublished report.

The findings contained in a draft report being drawn up by the Family Planning Association (IFPA) amke for uncomfortable reading.

The general consensus among the focus groups on which the IFPA report is based is that there is no effective sex education programme in secondary schools. Some participants said that there was no sex education whatsoever in their school.

"For those that did receive sex education, they found it to be inadequate. Many teachers were too embarrassed to go into detail about sexual health. In some cases a video presentation, which only focused on the biological aspects of sex and ignored the emotional aspects as well as the options available , was the only sex education given," states the draft report. "In addition to this it did not inform about sexual acts other than vaginal intercourse, such as oral sex, petting or anal intercourse."

The study is based on reports from a number of focus groups in Dublin, Limerick, Galway, and Cork.

In January & February the Irish Family Planning Association, and a number of partner organisations based in these areas, organised the focus groups of young people between the ages of 16 and 22 on the issues of sexual health education, information and services.

The following recommendations were made by the focus groups, which were organised by the Sexual Health Centre in Cork, Aids West in Galway, The Red Ribbon Project in Limerick and the Ballybough Youth Project in Dublin:

Make sex educationin secondary schools compulsory and included in the Junior and Leaving Cert examinations so all students have access to it and specific guidelines can be set down.

Teach sex education as a separate entity from religion; and ensure religious doctrine does does not impeach on the teaching of sex education.

That sex education incorporates biological and physical aspects of penetrative sex an the emotional and mental aspects of a healthy intimate sexual relationship, including the various options available to those who are, or will be, sexually active; fully covering safer sex parctices.

That an external person, trained in sex education, be brought to the school to inform them of sexual health and wareness. Should an external person be unavailable, a targeted staff member, with whom the students feel comfortable discussing the topic of sex, should be properly trained in sex education and be open to fully discussing this topic in class with students.

All information given regarding sex education should be up to date and relevant and should be accompanied by the opportunity to ask questions and receive full answers.

There's no douby that something's missining in the Irish sex education programme - the meteoric rise in the number of notified sexually transmitted diseases among teenagers in recent years points to a glaring deficiency in the system.

The increase is a cause for serious concern for those working in the sexual health sector. They say young people are simply not getting the message that STIs ar a very serious health risk.

"The lack of awareness of sexually transmitted disease is a huge issue," says Teresa McIlhenny, senior health promotion officer with the Health Services Executive Southern Area.

IFPA medical director Dr Sheila Jones describes the sex education programme as "very patchy" and says the attitude of teachers varies enormously. "Some teachers are very entusiastic some are not; it is not just sex or biology, they need to learn about life skills," she says.

"Countries which have very good sex education find youngsters tend to become sexually active later. Britain and America and Ireland - where the sex education is patchy - are among the worst for teenage pregnancies and STIs." As it stands the programme is simply not enough to meet the needs of teenagers, according to the IFPA.

A social personal health education curriculum is in place for primary level and up to the second-level junior cycle, but not yet for the senior cycle, which is currently served by interim guidelines on relationships and sexuality education. What's needed is a sexual health strategy which not only deals with the information and service needs of young people, but also addressed the huge deficit in sexual health information and services for all age groups, says Rosie Toner, the IFPA's director of counselling.

Throughout Europe, oung people have access to tailored services: in Sweden, young people can attend their school nurse for information and services in Britian the network of Brook Clinics is available ot young people. However, here in Ireland there is limited service provision.

"Most young people go through their teens without any access to sexual health services. The sexual health needs of young Irish people are no different from their European counterparts. It's time their needs were met," she says.

Gemma Tuffy of the Association of Secondary Teachers of Ireland agrees that a more holistic approach is needed. "Schools feel a lot of pressure is put on them to provide an ever expanding curriculum. One of the common complaints from teachers is that something like sex education in not an issue that can be just parked at the school door.

There needs to be a more integrated sexual health education policy, taking into account the Health Service Executive's health promotion officials, parents, doctors, etc...Schools simply have not got the resources themselves to develop this kind of approach - most schools would not ahve a home/school liaison teacher," she says.

Research has shown that for most pupils, learning about sex occurred well before they had received formal sex education at school. Some pupils recalled having had some indication about sex from the age of seven or eight, through friends, siblings, the media, and through snippets of information released by adults. For the majority of participants, though, "the talk" received in fifth or sixth class was a landmark in terms of their formal learning about sex.

A considerable number of participants, including those in the Leaving Certificate year, reported that they had not received any sex education at all since primary school. Others reported receiving sex education in isolated talks in some years of secondary school but not each year. In addition, there was a strong sense of hit and miss about the way in which sex education classes were organised. Only a small minority stated that they received sex education in each of the years at secondary school and while they did receive the basics, they felt they needed more detail.

Althought the sex education programme was the focus of bitter controversy in the 1990s, in recent years, according to Geraldine Graydon of th National Parents Council post-primary, there have not been many complaints from parents. Originally, parents were upset because they were concerned that the material was "too graphic" for primary school children, she say, but adds "there was misinformation at the time and a lot of parents became concerned."

Since the introduction in 2003 of the revised curriculum, in which parents and teachers were involved, says Graydon, there has not been much objection to the new curriculum. She describes the new programme as a much broader and more inclusive one which incorporates health and social education. "I think the way society in Ireland is going, parents are now beginning to see the need for sex education and the issues around equipping young people to say 'no' and how to say no," says Graydon.

The Department of Education said nobody was available to comment on the school sex education programme.

Learning From Others

If countries such as Canada, Finland, and the Netherlands have lower rates of teenage pregnancy and STIs, can we learn from their experience? This question has formed the basis for numerous studies.

Some researchers postulated that the variation in levels of teenage pregnancy and sexually transmitted infections (STIs) lies in other countries' comprehensive relationship and sex education programmes; greater societal openness regarding sex and accessible sexual health services.

So what's wrong in Ireland? "Even though it's compulsory in schools at both primary and second level, it's very much up to the schools as to lhow much of the sex education programme they implement," says IFPA chief executive Niall Behan. " In some schools it is implemented very well. They just get medical support and look at best practice internationally and at home. Other schools don't go into the issues around contraception. They are unsure how they should implement the section on contraception."

Some schools, he says, simply look at the practicality of sex without looking at the emotional side or the negotiating skills around how teenagers deal with the issue sex when it arises. So what should be added to the Irish sex education programme? "Teachers do not have good resources such as booklets, videos. Sex education should be more age appropriate as yong people are getting it too late. Information about contraception is coming too late. They need it before they become sexually active - about the age of 12/13. There also needs to be better guidelines and more control over what is taught."

Behan believes more emphasis needs to be placed on social skills as well as the biological facts. "We need a dedicated youth family planning clinic for our young people. It would be a resource centre where teachers, youth workers, media, etc, can get advice along the lines of the Brook Family Planning in the UK and Northern Ireland, which is specifically targeted at under 25 year olds."

How we compare to the Swedes

Sweden's teenage fertility rate is one of the lowest in the EU, and substantially lower than Ireland or the UK, Portugal, the Netherlands, or Norway. At 6.9 births per 1000 in 2002, it contrasts sharply with Ireland's figure of 19.42 births. However, it is important to note that the teenage fertility rate does not take account of the high teenage abortion rates in Sweden (18 per 1000 in 2002) compared to Ireland (6 per 1000 in 2002).

Since the early 1970s youth clinics have been functioning in towns throughout Sweden. Doctors and nurses form the clinic join in sex education programmes at the local schools, integrating medical care with the sex education programme and opening clear lines of communication and information. Adolescents are educated and counselled before they become sexually active. They are specifically encouraged to attend the youth clinic before embarking on a relationship. When they do, they are greeted by familiar staff who taught them at school and who provide a welcoming clinical service with advice on sexuality, interpersonal relationships, contraception, and avoidance of sexually transmitted diseases.

Contraception, termination, diagnosis and treatment of lower genital tract infections, cervical cytology, and contact tracing are available. In Sweden the introduction of youth clinics has led to a significant reduction in the incidence of teenage pregnanies, terminations, gonococcal and chlamydia infections, pelvic inflammatory disease, and ectopic pregnancy.-